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Isotretinoin for severe acne

If your acne is really bad or it's not getting better after six months of treatment, then your doctor may consider that you try a medicine called isotretinoin (brand names Oratane, Isotane, Roaccutane). This treats acne effectively, but has many possible side effects, so it doesn't suit everyone.


Pregnant women, or women who might get pregnant, must not use isotretinoin, as it causes miscarriages and severe birth defects. If you are a woman of child-bearing age, and are taking or considering taking isotretinoin, you'll need to have pregnancy tests. You will also need to take two forms of contraception for a month before taking the medicine, during treatment, and for one month after stopping it.

Not all GPs prescribe isotretinoin – this depends on their particular experience and training, and also how easily they can see you for follow-up. If your GP is not comfortable prescribing isotretinoin for you, they may refer you to another GP with more experience in prescribing it, or to a dermatologist – either at Christchurch Hospital, or privately.

Monitoring while on isotretinoin

Because of the possible side effects and risk in pregnant women, if you are taking isotretinoin, you'll need to see your doctor regularly to monitor your health.

The tests you'll need to have regularly include:

Your GP will also monitor your mental health, for example checking for signs of depression.

If you are a woman of child-bearing age, you will need to have a pregnancy test before starting isotretinoin, one month after starting, and occasionally more often.

Your GP or dermatologist will also want to check how your acne is responding to the medicine, and see if you need to change the dose you're taking.

On the next page: More information about acne

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Written by HealthInfo clinical advisers. Page created March 2017


Page reference: 37456

Review key: HIACN-20774