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Isotretinoin (Accutane) is typically a 6 month course. If you cannot tolerate the medication, we can sometimes lower the dose and treat you for longer than 6 months. You MUST NOT get pregnant on the medication. For females, two forms of contraception are required at all times. Things to remember:
  • You will need bloodwork done before each visit. It helps to do this 2 days prior to your appointment so we have the results ready when you are here. Typically you should try to be fasting for the bloodwork.
  • You MUST fill the prescription (pick up the medicine) within 7 days of the bloodwork date. If you are a female, the prescription will expire and you will be locked out for an entire month.
  • Stop all other acne medications while on Accutane, including antibiotics, prescription topicals, and over the counter acne washes. They will increase your side effects if you continue them.
  • If you see another doctor while on Accutane, inform them that you are on it. If you are prescribed other medications, it is a good idea to ask your doctor, the pharmacist, or us if it is okay to take them together.
  • You can take a normal multivitamin, but do not take more than 5000 IU of Vitamin A per day (there should not be more than this in a normal multivitamin).
  • Use mild cleansers such as Cetaphil gentle skin cleanser or Cerave hydrating cleanser.
  • Use moisturizers daily such as Cerave AM and PM and Cetaphil oil control. Use Cerave cream (in a tub) for the body.
  • Use Aquaphor or petroleum jelly daily to the lips. If the lips become problematic, try Dr. Dan’s Cortibalm.
  • Discontinue alcohol use while on Accutane. Also avoid Tylenol products. Ibuprofen is better while on Accutane, unless you have a contraindication to it.
  • If you wear contact lenses, lubricate your lenses well before inserting or removing them. Do not ever sleep in them. We recommend lubricants such as Refresh Tears or Refresh PM.
  • If your nose becomes dry, nosebleeds can occur. Use Ayr nasal gel or saline solutions to help with this.  If nosebleeds are excessive and won’t stop with normal pressure, go to an emergency room or urgent care that is on your insurance plan.
  • Minimize hair waxing, tweezing, and threading while on Accutane. You may experience prolonged redness, burns, or skin erosions. Always inform anyone performing these treatments that you are on Accutane.
  • Do not have any chemical peels, laser treatments, body piercings, tattoos, or elective surgical procedures while you are on Accutane or for the 6 months following completion of the medication. If you have darker skin, we sometimes recommend waiting even longer – 1 year.
  • Minimize sun exposure while on Accutane. Use a sunscreen of SPF 30+ daily and SPF 50+ if you will be outside. Keep a hat and long sleeves with you. Avoid sun exposure between 10 am and 4 pm. We have seen terrible sunburns on Accutane. You have to protect yourself!
  • Consider taking 2 fish oil pills at night to help with dryness and your triglycerides.
  • If you have any headache along with blurring of the vision, this needs to be reported immediately to the office. The medication needs to be stopped and you will need an ophthalmologist to look at the back of your eye. 
  • You must come for your follow-up visits. If you have to reschedule, make sure you come in as quickly as you can so that your Accutane schedule does not get delayed. If you run out of Accutane for a few days prior to your next visit, that is not a problem at all. It is perfectly fine to be off of the medication for a week or two without decreasing the efficacy of the medication.
  • Patients that continually miss appointments will have their Accutane treatment terminated.
  • When done correctly, Accutane is a very effective medication, but we have to adhere to these guidelines to ensure your health and make sure your experience with the medication is a good one.