What is Roaccutane?

Reviewed by our clinical team

Acne is a really common skin condition that causes oily skin and spots, normally across the face, chest, and back.

For people with severe acne, one treatment option is isotretinoin, which is often prescribed under the brand name Roaccutane. This treatment comes in capsule form, and is designed to be taken once or twice a day, normally for a period of four to six months.

Though it can be really effective in preventing acne symptoms, Roaccutane is associated with some significant side effects, and should only be taken under the supervision of a specialist. Read on to learn more.

How does Roaccutane work?

To understand how Roaccutane works, you first have to understand the causes of acne.

The sebaceous glands are located close to the surface of the skin, and are attached to our hair follicles (the holes that hairs grow from). These glands produce sebum, an oily substance that keeps the hair and skin lubricated.

In people with acne, the sebaceous glands produce too much sebum. This mixes with dead skin and plugs the hair follicles. If a plugged follicle becomes infected by bacteria on the skin, it can develop into a painful spot like a pustule or a cyst.

The active ingredient in Roaccutane, isotretinoin, works to prevent acne symptoms in two ways:

• By reducing the amount of sebum that your sebaceous glands produce 
• By killing bacteria on the skin that can infect plugged follicles

Isotretinoin is also thought to have anti-inflammatory properties, which means it can help to reduce redness and swelling.

Why is Roaccutane prescribed and who can benefit?

Roaccutane is only prescribed by specialist doctors (dermatologists) to teenagers and adults who have severe acne. According to the NHS, severe acne is characterised by “lots of large, painful papules, pustules, nodules or cysts”. It might also cause scarring.

Roaccutane is only prescribed in severe cases where acne has not responded to other treatments. This is because it’s associated with some significant side effects and complications.

Who shouldn’t take Roaccutane?

For certain groups of people, Roaccutane is not a safe treatment.

People who are pregnant or breastfeeding should avoid it altogether as it can be harmful to the child, and increase the risk of miscarriage.

The risks are so high that women are advised to take extra precautions to prevent pregnancy while having Roaccutane. The NHS recommends using two methods of contraception, and taking pregnancy tests before, during, and after treatment.

Roaccutane will also be unsuitable for people who have:

• Depression or another mental illness 
• Liver or kidney disease 
• High cholesterol 
• High vitamin A 
• Crohn’s disease or ulcerative colitis 
• An allergy to isotretinoin or the other ingredients in the capsules (e.g. soya)

How long does Roaccutane take to work?

If you take Roaccutane as directed, your skin should start to improve after about seven to 10 days. Before this point, your acne symptoms may temporarily get worse, so it’s important to stick with the treatment.

Roaccutane capsules are taken once or twice a day. One treatment course is usually for four to six months. After you finish, your skin might continue to improve for up to eight weeks. Most people's skin is completely clear after finishing the treatment. Further courses of Roaccutane are usually not needed. 

Possible side effects of Roaccutane

The most common side effects of Roaccutane are dry skin and dry lips, and increased sensitivity to sunlight. While you’re taking Roaccutane, you’ll need to avoid any treatments that might irritate the skin, like waxing or dermabrasion.

Other common side effects are dry eyes, dry throat, dry nose, nosebleeds, headaches, and aches and pains.

Serious side effects are much less common, however it’s still important to be aware of them. In rare cases, Roaccutane can cause the following:

• Mental health issues and mood changes  
• Severe stomach pain 
• Nausea and vomiting 
• Bloody diarrhoea 
• Blistering skin rashes 
• Muscle weakness 
• Yellow skin or yellow whites of the eyes - this can be a sign of a liver problem 
• Difficulty urinating - this could be a sign of a kidney problem 
• Bad headaches that make you feel sick 
• Changes in eyesight

If you experience these kinds of symptoms, you should stop taking isotretinoin right away and get medical advice.

Other treatments for acne

There are plenty of acne treatments available. If you can't take or don't want to take Roaccutane, it’s still worth visiting your GP or skin specialist to discuss your options.

Other treatments for acne include:

• Antibiotic tablets (usually taken for three to six months) 
• Co-cyprindiol (also known as Dianette, this is a special oral contraceptive pill) 
• Topical treatments like adapalene, azelaic acid and benzoyl peroxide

Antibiotic tablets work better if they are combined with topical treatments.

If you’re interested in trying these kinds of treatments, visit Online Doctor’s acne clinic. We can prescribe a range of effective solo or combination treatments that should help to clear your skin.

References

https://www.nhs.uk/conditions/acne/causes/
https://www.nhs.uk/medicines/isotretinoin-capsules/
https://www.nhs.uk/conditions/acne/diagnosis/
https://www.nhs.uk/conditions/acne/treatment/