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  • Dry skin: especially on exposed skin (face, neck, arms, and hands). Apply an emollient cream frequently and liberally to dry skin, especially after bathing.
  • Dry nostrils: use petroleum jelly. Do not pick the dry scabs. Nosebleeds may occur in those disposed to them. If this occurs put your head forward and pinch the fleshy part of your nose firmly. Do not swallow the blood (this could make you feel sick). The bleeding usually stops within a few minutes. Topical antibiotic may reduce nosebleeds.
  • Dry eyes: severely dry eyes are sore and red. There is a risk of conjunctivitis and/or keratitis, an inflammatory condition of the cornea. Rarely, this scars. Stop your isotretinoin and contact your dermatologist if you have sore red eyes that fail to improve with “artificial tears” (eye drops). Sometimes, paradoxically, patients complain of watery eyes. Do not start wearing contact lenses for the first time while you are taking isotretinoin. Do not have elective eye surgery or laser treatments (e.g. LASIK) while taking isotretinoin or for 6 months afterwards.
  • Dry genitals and anal mucosa: bleeding at the time of a bowel motion may occur from a split anus. Sexual intercourse may be uncomfortable: use plenty of suitable lubrication such as K-Y Jelly or Silk.
  • Fragile skin: minor injuries such as grazes occur more readily and heal more slowly. Shave rather than wax. the top layer of your skin may strip off as well the hairs!
  • Increased sweating: keep cool.
  • Facial erythema (redness) &/or flushing: most noticeable in fair skinned people.
  • Sunburn. a particular problem for fair skinned people. Careful sun protection is most important. All the year round, make sure you apply a cream-based sunscreen before going outdoors. Apply it frequently and liberally if you are skiing in the spring at high altitude, or if outside during the summer months between 11 am and 5 pm. Do not expose your skin to a sun bed or sun lamp.
  • Eczema. red itchy patches may appear on the dry skin. A topical steroid may be required for a few days to clear the rash: obtain a prescription from your doctor or dermatologist. Apply emollients liberally and frequently.
  • Impetigo. a secondary infection with Staphylococcus aureus and/or Streptococcus pyogenes bacteria. Impetigo is also known as “school sores”; there are yellowish crusted patches, most often around the lips and nostrils or affecting the acne spots. See your doctor for a course of topical and/or oral antibiotics.
  • Pyogenic granuloma. red juicy lumps may rarely appear around acne nodules or elsewhere. See your dermatologist for treatment (topical steroids & cautery).
  • Paronychia. an infection of one or more nail folds, usually with Staphylococcus aureus. It is especially common in ingrowing toenails or nails that are chewed or picked. Paronychia can be particularly stubborn and resistant to treatment but settles once the isotretinoin has been discontinued.
  • Hair loss: some hair may fall out temporarily, and the hair may lose condition. It grows normally once the isotretinoin has been stopped. Normal shampoo and conditioners may be used but won’t influence the hair fall. If the scalp is scaly, an anti-dandruff shampoo twice a week may help.
  • Nail changes: the nails may become brittle and slow growing. They recover when treatment has been discontinued, but it will take several months for the new healthy nail to grow out.
  • Acne flare early

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