Alright, this post is for my younger friends.
Today, we’re talking about isotretinoin, otherwise known as accutane, and some supplements that you can take to offset some of the common side effects that you get from taking this med.
Okay, let’s start with a little background. Isotretinoin, again also known as accutane, is medicine that’s given to people with severe acne, which are usually teenagers. In my own clinic, I occasionally have a handful of adults who end up needing isotretinoin due to persistent acne that’s not well controlled with other meds. It’s hands down the most effective medicine for treating acne.
Mechanistically speaking, isotretinoin is synthetic form of vitamin A that treats acne by reducing oil secretion by literally killing off oil secreting cells. It’s also a potent anti-inflammatory and can reduce acne lesion count by reducing inflammation in the skin.
Despite it being so effective, it has a TON of side effects. These most commonly include dry skin, dry lips, nosebleeds, skin rash, headaches, muscle aches, joint aches, and less commonly thoughts of suicide, depressed mood, bone growth abnormalities, increased intracranial pressure, cholesterol elevations, and medication-induced hepatitis. It’s controversial and most of the science shows that it is NOT linked to inflammatory bowel disease (IBD), but there are some patients in which taking isotretinoin can make IBD worse.
So, whenever I give isotretinoin to my patients with severe acne, we usually ask a lot of questions to make sure that they’re not at risk for some of these complications.
As I just mentioned, the most common side effect of taking isotretinoin is dry skin and lips, which can be so severe. The study that I want to share with you today is one that gives me hope with respect to managing these dry skin and lip side effects. It was just published in October of this year and it specifically looked at how natural supplements (AKA nutraceuticals) can offset some of the side effects from taking isotretinoin.
Alright, so, it’s a meta-analysis, which means that it’s a review of all of the existing medical studies looking at this question—the question being, can certain supplements reduce the side effects of isotretinoin? And, I’m happy to report that the answer is yes.
So, more than 93 papers were initially assessed for eligibility and 8 ended up meeting the inclusion criteria for this study. The authors of this paper found two randomized controlled trials that showed that taking omega-3 fatty acid supplements reduced the rate of having dry skin and dry lips from taking isotretinoin. One study showed that the dose 1 mg/kg/day was effective, whereas the other study showed that taking 1 gram per day worked to offset dry skin and lips. This dose was also found to reduce symptoms of nasal passage dryness so conceivably it also helped with nosebleeds.
Two other studies showed that evening primrose oil, which contains omega-6 fatty acids, reduced dry skin and dry lips, also.
And lastly, one study found that taking zinc sulphate 1 mg/kg/day reduced the need for higher doses of isotretinoin. In other words, if you take low doses of isotretinoin, you can take zinc supplements and have the same benefit as if you were taking high doses of isotretinoin.
Pretty cool, right? So, here’s a quick summary.
If you take isotretinoin, you may benefit from taking omega 3 fatty acids. Look to take 1 gram daily. You may also benefit from taking evening primrose oil—the study showed that doses between 1.3 and 2 grams per day were effective at reducing skin and lip dryness. And, zinc sulphate 1 mg/kg/day can reduce your need for higher doses of isotretinoin.
Alright my younger friends, there you have it. Enjoy less side effects from taking accutane if you try some of these supplements.
Reference
Shields A et al. The role of oral nutraceuticals as adjunctive therapy to reduce side effects from isotretinoin: a systematic review. J Am Acad Dermatol 2023.