Looking after your skin while on isotretinoin (Accutane/Roaccutane)

Isotretinoin is a fantastic drug to clear acne but has some side-effects. It works by drying out the sebaceous glands - these are the glands which produce sebum and keep the skin surface welllubricated. In individuals with acne, these glands can be a bit too enthusiastic and produce an overly oily complexion which can lead to spots. There are three essential products you will need to consider while taking the medication: Lip balm, Facial moisturiser & Cleanser

Lip balm

The data suggests that over 95% of people taking the drug will develop dry lips. In my own experience, the percentage is closer to 100% and if you don’t get it, I’d recommend checking your DNA to make sure you’re completely human! There a range of products that you can try - my own experience has been that Eucerin Aquaphor SOS Repair Lips outperforms the majority of competitors by a long way. The product contains glycerine which helps provide a layer of protection that lasts a long while. The downside is the cost - it isn’t cheap. If you’re on a budget, don’t knock good old-fashioned Vaseline Petroleum Jelly. You can get a generous sized 250 mL container for under £3. Quantity is key - a thick layer, applied every few hours can do the same job as the fancier products, for a fraction of the price. Some people have very sensitive lips and these can crack despite being meticulous with lip balm. In those cases, we often prescribe a steroid cream that can help settle things down very quickly. Regardless, prevention is better than cure and, in the vast majority of cases, we can manage the dry lips without needing to add anything else into the mix. Caution: some people can react against certain ingredients within lip balms. If you have very sensitive skin, or have had previous issues with skin reactions, please let us know and we’ll make personalised recommendations that will prevent this.

Moisturiser

As we’ve already touched on, the drug works by drying out the sebaceous glands. Thus, the skin dries as the glands are sent to sleep by the medication. Your skin still needs a layer of moisture to help protect it from the baddies out in the real world (e.g. pollution, air conditioning, infectious bugs) as well as to keep it supple and fresh.

There are a huge range of moisturisers you can try but remember - this isn’t a free-for-all in which you can pick a random moisturiser and hope for the best. Some moisturisers can clog up the skin, stop it from breathing, and so can trigger even worse flares of acne. The key thing to look out for on the label is non-comedogenic. This means that the drug doesn’t block up pores. Some of the available heavier moisturisers are built for people with eczema and are not designed for the exact context of isotretinoin-induced dryness.

These two brands (CeraVe and Cetaphil) we tend to like:

CeraVe AM Moisturising Lotion - this light moisturiser contains a sprinkling of sun protection (SPF25) as part of the deal. The cocktail of ceramics help protect the natural barrier of the skin while hyaluronic acid helps lock in moisture. It absorbs in well, doesn’t leave residue and, most importantly, doesn’t drive more spots.

CeraVe PM Moisturising Lotion - this is a slightly heavier product that is best used at night to help nourish and rejuvenate the skin. Assuming that you don’t live in a parallel universe, you won’t need SPF at night - and this is the key difference between the AM and PM products.

Cetaphil Daily Hydrating Moisturiser - While the name isn’t as cool-sounding as CeraVe, this is a pretty solid moisturiser that is lightweight and absorbs in quickly. It also contains hyaluronic acid which is helpful at keeping that all-important moisture locked in

Cleanser

Regardless of your natural skin type (dry, oily, combination), isotretinoin will dry out your skin. We therefore suggest going for products which are geared towards sensitive/dry skin.

La Roche-Posay Toleriane Foaming Gel Cleanser - This is a rinse-off gel cleaner which is loaded with glycerine. It will help keen your skin feeling refreshed, relieved and clean. It is entirely free of parabens, fragrant and alcohol which should help reassure even those with the most sensitive skin.

CeraVe Hydrating Facial Cleanser - Similar to the rest of the CeraVe range, this hydrating cleanser contains a range of ceramides and hyaluronic acid helping to keep in moisture.

Avene Extremely Gentle Cleanser - We like this simple, milky formulation that cleanses without stripping the skin. Hey, Cleopatra liked bathing in milk for a reason...