Isotretinoin - Side Effects And Treatment

Dry lips are the most common side effect of Isotretinoin (Accutane®). If your patient is on a course of Accutane® and their lips are not dry, then they are either not using the drug, or they are not taking the medication with fatty food. Sticky ointments are best for relieving this dryness and may prevent cracking, these products must be used multiple times a day. Occasionally, patients may get a secondary bacterial infection on their lips, this will usually respond to topical antibiotics. Some physicians will advise a few days of mild cortisone ointment for their patients if they have significant inflammation on and around their lips. With dry skin, you may see this most often on the back of your patient's hands and forearms.

Dryness may cause a secondary bacterial infection in their skin, their skin may become fragile and the healing of their skin may slow down. We often forget about protecting our lips from chronic sun damage, long term exposure will often produce "actinic cheilitis", which describes changes such a loss of a distinct lip line, and white patches on the lower lip called leucoplakia. These changes are precancerous and we should take care to protect our lips to reduce this occurrence.

Those who are prone to cold sores may get them more frequently after sunexposure. Those taking Accutane® will have dry lips that are more sensitive to sunburn.
Regular sunscreens are not entirely satisfactory for lip protection, and a number of lip sunscreens have been developed. Rarely, night vision problems have been reported, they are mostly transient, but could be permanent. Loss of visual acuity is uncommon but if your patient does experience this, an ophthalmologist should assess them. Dry gritty eyes, contact lenses may have to be discontinued; use of artificial tears is encouraged and in most cases can be very helpful.