Roaccutane Side Effects: What Patients Need to Know
- Amit Goyal
- 22 hours ago
- 6 min read
If you are considering Roaccutane treatment for acne, one of the most important things to understand is the potential for side effects. Roaccutane, also known as isotretinoin, can be a highly effective treatment for severe acne, but it is a medicine that must be prescribed and supervised carefully because it can cause both common and serious side effects. NHS guidance states that isotretinoin capsules are for severe acne and must be prescribed and supervised by a specialist doctor.
At mySkinDoc, we believe patients should have clear, honest information before starting treatment. Many people know Roaccutane for its ability to improve severe or scarring acne, but fewer understand what the side effects can feel like in day-to-day life, what is common, what is less common, and when to seek medical advice.
This guide explains the main Roaccutane side effects, how they are monitored, and what UK patients need to know before starting treatment.
What is Roaccutane?
Roaccutane is a brand name commonly used for isotretinoin, an oral retinoid related to vitamin A. It is used for severe acne, particularly when other treatments have not worked well enough or when acne is at risk of causing permanent scarring. In the UK, it is prescribed under specialist supervision because treatment requires careful counselling, monitoring, and risk management.
Why do side effects happen with Roaccutane?
Roaccutane works by shrinking the skin’s oil glands and reducing sebum production. That is one of the reasons it can be so effective for acne, but it is also why dryness-related side effects are so common. British Association of Dermatologists guidance lists dry lips, dry skin, dry eyes and increased sun sensitivity among the common effects patients may notice during treatment.
The most common Roaccutane side effects
Dry lips
Dry, chapped or split lips are among the most common side effects of isotretinoin. Many patients need regular lip balm throughout treatment. BAD specifically lists dry lips as a common effect.
Dry skin
Because Roaccutane reduces oil production, skin often becomes dry, delicate or more easily irritated. This may affect the face, hands and other areas of the body. BAD notes that skin can become drier and more delicate than usual during treatment.
Dry eyes
Some people develop dry or irritated eyes, and contact lenses may feel less comfortable while taking isotretinoin. Dry eyes are listed in BAD patient guidance as a common side effect.
Dryness inside the nose and nosebleeds
Dryness of the nose can lead to irritation and sometimes nosebleeds. NHS formulary references and other NHS sources note dryness of mucous membranes and nosebleeds as recognised side effects.
Increased sensitivity to the sun
Skin can become more sensitive to sunlight while on isotretinoin, which means patients may burn more easily. BAD guidance highlights increased skin sensitivity to the sun as a common issue.
Muscle, joint or back aches
Some patients notice aching in the muscles, joints or back, especially after exercise. BAD lists back pain and muscle and joint aches among the possible side effects.
Blood test changes during Roaccutane treatment
Roaccutane can cause changes in blood tests, which is one reason monitoring is so important. BAD notes that isotretinoin may cause mildly raised liver enzymes and changes in blood fat levels, and these are typically monitored by the treating team. Some NHS guidance also notes that blood sugar may need closer monitoring in certain patients, such as those with diabetes.
This does not mean every patient will develop a significant problem, but it does mean blood tests and follow-up reviews are an important part of safe treatment.
Mental health and sexual side effects
Current NHS and UK regulatory guidance makes clear that isotretinoin can have serious side effects, including side effects that may affect mental health and sexual health. Patients should be informed about these risks before treatment starts, and the 2026 MHRA update says patients must be given age-appropriate written information about possible mental health and sexual function side effects, including that some reported effects may continue after treatment.
This does not mean that every patient will experience these problems, but it does mean treatment should begin only after proper counselling and with ongoing review. Patients should promptly report any worrying changes in mood, mental wellbeing or sexual function to their clinician. That follows from the NHS and MHRA emphasis on informed risk discussion and monitoring.
Pregnancy-related risks
One of the most important risks with isotretinoin is pregnancy. UK government safety guidance states that isotretinoin can seriously harm an unborn baby, and pregnancy-prevention requirements remain in place. Patients who can become pregnant must follow the relevant pregnancy prevention rules and should not become pregnant during treatment or for 1 month after stopping isotretinoin.
Because of this, Roaccutane should only be prescribed where these safety measures can be properly followed.
Can acne get worse at first?
Yes, sometimes. BAD patient information on acne notes that with isotretinoin, acne can worsen for a few weeks before it starts to improve, and progress is usually gradual over the course of treatment.
This early flare can be discouraging, but it does not necessarily mean the treatment is failing.
Are Roaccutane side effects always severe?
No. Many side effects are common but manageable, particularly dryness-related symptoms such as dry lips and dry skin. However, Roaccutane is still a medicine with potentially serious risks, which is why NHS guidance says it must be prescribed and supervised by a specialist doctor.
A balanced way to explain this to patients is:
some side effects are common and expected
some are less common but important
proper monitoring is there to reduce risk and identify problems early
How are side effects monitored?
The current UK framework around isotretinoin places strong emphasis on informed consent, written information, and monitoring. The 2026 MHRA update says existing risk minimisation measures remain in place, with additional measures to support safe prescribing and monitoring. BAD also provides a side-effects questionnaire and follow-up resources to support reviews during treatment.
In practice, monitoring often includes:
reviewing symptoms and tolerability
checking for dryness and other physical side effects
considering mental health and sexual side effects
arranging and reviewing blood tests where appropriate
confirming pregnancy-prevention requirements where relevant
What can help with common side effects?
While individual advice should come from the prescribing clinician, patients commonly need simple supportive measures during treatment. Based on the dryness profile described in BAD and NHS materials, practical measures often include:
frequent lip balm
a gentle moisturiser
careful sun protection
simple, non-irritating skincare
lubricating eye drops if advised
reporting troublesome symptoms early rather than waiting for the next review
These measures do not replace medical supervision, but they often make treatment much more comfortable. The need for regular lip and skin moisturising is reflected in BAD and NHS-associated patient information.
When should patients seek urgent advice?
Patients should contact their treating clinician promptly if they develop side effects that feel significant, unusual or worrying, especially if they involve mood, mental wellbeing, sexual function, severe physical symptoms, or pregnancy concerns. This is consistent with NHS and MHRA guidance that isotretinoin has potentially serious side effects and requires close supervision.
Final thoughts
Roaccutane can be one of the most effective treatments for severe acne, but it is important to go into treatment with a clear understanding of the possible side effects. The most common issues are usually dryness-related, such as dry lips, dry skin, dry eyes and sun sensitivity, but there are also more serious risks that require proper counselling and monitoring, including effects on mental health, sexual health, blood tests and pregnancy safety.
For patients considering private Roaccutane treatment in the UK, the key message is that treatment should be specialist-led, well monitored, and based on informed consent. At mySkinDoc, safe prescribing and clear patient information should always come first.
FAQs
What are the most common Roaccutane side effects?
The most common side effects are usually dry lips, dry skin, dry eyes, sun sensitivity, and sometimes muscle or joint aches.
Can Roaccutane affect mental health?
NHS guidance says isotretinoin can have serious side effects, including side effects that can affect mental health. Patients should be counselled about this before treatment starts.
Can Roaccutane affect sexual health?
Yes. NHS and BAD/MHRA resources state that patients must be informed about possible sexual side effects, including that some reported effects may continue after treatment.
Why do I need blood tests on Roaccutane?
Blood tests are used because isotretinoin can affect liver enzymes and blood fats, and some patients may need additional checks depending on their health background.
Is it normal for acne to flare at the start of treatment?
It can be. The BAD notes that acne may worsen for a few weeks before improving.
If you feel that Roaccutane would be suitable then we would be happy to make an assessment for you to discuss the best way to treat you and your acne.
