Roaccutane has been touted as the miracle cure for most cases of acne. We speak to the Cape Skin Doctor, dermatologist Dr Nomphelo Gantsho, to learn more about this drug and how best to manage the course of treatment

Isotretinoin, the medical term for drugs distributed as the brands Acnetane, Roaccutane and Oratane in South Africa, has been proven to help those who suffer from acne so severe that it’s affected the quality of their lives.

This prescription drug, which is said to be the closest thing to a cure, can potentially clear severe acne and improve quality of life for those who have become anti-social and socially anxious because of the condition of their skin.

We sat down with the Cape Skin Doctor, Dr Nomphelo Gantsho, to discuss isotretinoin and how best to look after body and mind when on this extremely potent medication.

What are the side effects associated with isotretinoin? 

The side effects range from person to person; the dose prescribed also contributes and the disease being treated. Most side effects are on the skin and areas that have fluid – the mouth, eyes, nose and genitals.

The most common side effects associated with isotretinoin use are:

• Acne flare-up (particularly in the first month)
• Dry lips; cheilitis (sore, cracked or scaly lips)
• Fragile skin that’s easily injured; itchy, dry skin (eczema)
• Dry, watery or irritable eyes (especially for those who wear contact lenses), conjunctivitis, keratitis
• Dry anal mucosa; bleeding at the time of a bowel motion
• Dry genitals; dyspareunia (discomfort during intercourse)
• Reddening of the face
• Sunburn on exposure to the sun due to increased sensitivity

A sudden decrease in night vision may also occur while taking isotretinoin. Be cautious when driving at night and avoid doing it if you experience decreased night vision.

How does isotretinoin affect the hair?

Some people can experience temporary hair loss and thinning, so it’s advisable not to choose hairstyles that involve vigorous manipulation of the hair.

Isotretinoin also impairs the ability to heal, so users should be very careful about what they do to their scalp. Sometimes people also experience dandruff while using isotretinoin, which may put them off braiding their hair.

How can you protect the skin on your body from drying out while on isotretinoin?

Moisturise your skin when it gets dry or feels uncomfortable. A basic water-based moisturiser is all you need. Taking care of your lips is also essential – you should moisturise them regularly to prevent them drying out and chapping.

When skin is irritated take short, cool showers without using soap, to alleviate irritation. Also use a mild or diluted shampoo to wash your hair to prevent scalp irritation. Another way to look after your skin while on the medication is to shave instead of wax when it comes to hair removal.

If the side effects are unbearable, contact your dermatologist so the dose can be reduced.

What lifestyle changes should be made when using isotretinoin?

Women taking isotretinoin must not fall pregnant while on the treatment and for one month after using the drug because it causes birth defects. They’ll have to use two effective forms of birth control – an oral contraceptive and the barrier method – or avoid sexual intercourse altogether while on the treatment.

Do not drink alcohol while taking isotretinoin as it can cause abdominal pain, drowsiness or dizziness. Also, do not take vitamin A supplements or consume sports drinks that contain more than 40% of vitamin A.

Avoid cosmetic procedures to smooth your skin – including waxing, dermabrasion or laser procedures – while on the medication and for at least six months after you stop taking it. Isotretinoin can increase your chances of scarring from any of these procedures.

And it may cause sunburn more easily, so it’s essential to avoid the sun and use sunscreen.

Can women wear make-up while on the medication?

Women can still wear make-up while on isotretinoin – but the make-up must be non-comedogenic (doesn’t cause acne). It’s also important that they wear sunscreen with a high SPF under their make-up.

How should those on isotretinoin manage the course of their treatment?

Report any side effects that you experience while taking isotretinoin, don’t miss your follow-up appointments and do the necessary tests as instructed by your dermatologist.