Whether you’ve just been prescribed Isotretinoin (roaccutane), are in the middle of a course, or are coming off it, here’s your skincare survival guide

If you’re a severe acne sufferer  and have been prescribed roaccutane  by your doctor or dermatologist, you’ll have been warned of possible side effects alongside the benefits of taking it- for a lowdown on how the acne drug works, we’ve put together an expert’s guide to roaccutane  to guide you through pros and cons. One of the first offshoots of starting a course of roaccutane is often increased skin dryness and chapped lips and hands, which may come as quite a shocker if your skin has previously been very oily. As such, we asked consultant dermatologist and acne specialist Dr Anjali Mahto  for advice on how to adjust your skincare regime when you’re taking roaccutane, the best products the look out for and ingredients to steer clear of during treatment. The doctor will see you now…

How your skin might change while taking roaccutane

“Roaccutane has a tendency to make the skin dry and sensitive within a few days of starting treatment. The medication works by reducing the size and activity of the skin’s oil producing glands and nearly everyone will suffer from dry lips, in addition to varying degrees of dry skin. Skincare should be changed to reflect this, ideally as soon as the medication is initiated and certainly within the first week of treatment.”

Switching up your skincare routine

“The ideal skincare routine while taking roaccutane should be non-comedogenic  but geared towards dry and sensitive skin. Products that are alcohol and fragrance-free  are best. Personally, I’d recommend many of the French pharmacy brands, as for the most part they are effective and available at a reasonable price point.”

The cleansers

La Roche Posay Toleriane Dermo-Cleanser , £12.50

A sensitive-skin friendly daily cleansing milk that soothes and softens as it sweeps away grime and makeup.

Avène Extremely Gentle Cleanser , £10.50

A simple, milky formulation that cleanses without irritating or stripping the skin.

La Roche Posay Toleriane Foaming Gel Cleanser , £12.50

pH balanced and rich in moisturising glycerin, this rinse-off cleanser is refreshing, cooling and won’t leave skin raw.

The moisturisers

La Roche Posay Effaclar H , £16

The lightest of the bunch, this easily-absorbed lotion is formulated to hydrate combination to oily skin that has been through the wars due to aggressive acne treatments.

La Roche Posay Toleriane Ultra , £17.50

If skin feels tight and uncomfortable, this will restore balance and provide relief throughout the day.

La Roche Posay Toleriane Riche Soothing Protective Cream , £16

The richest option in this La Roche repertoire, shea butter brings SOS nourishment while emollient squalene help skin to look and feel supple, not sore.

Lip service

“Almost everyone on roaccutane will suffer with lip dryness and it is extremely important to make sure that multiple lip care products are bought and kept in each bag and coat or jacket pocket so that you don’t get caught out without it. Lips need to be moisturised frequently, otherwise they can become dry, cracked, swollen and painful.”

The lip balms

Elizabeth Arden Eight Hour Intensive Lip Repair Balm , £20

Good old Eight Hour swoops to the rescue once again- former acne sufferer Victoria Beckham swears by this restorative balm to keep flakiness at bay.

Dr PawPaw Balm , £6.95

The cult multi-purpose ointment is both antibacterial and helps lips to retain moisture, keeping them smoother for longer.

Eucerin Aquaphor Intensive Lip Balm , £5.99

Fragrance-free and stops cracked lips in their tracks.

Carmex Lip Balm , £2.69

The classic anti-chap remedy is affordable and effective.

Keep a cool head

“The skin of the scalp is also vulnerable to dryness.  During treatment, many people notice that their scalp becomes far less greasy and that they don’t need to wash their hair as frequently as before. That could be a bonus, but if the scalp becomes inflamed and problematic, consider the use of over the counter shampoos such as T-gel  or  Polytar  which may help to reduce scaling and irritation. Should the problem continue, have a discussion with your prescribing dermatologist, who can give you prescription shampoos with or without a mild steroid lotion to calm the scalp.”

Sun protection is more pressing than ever

Wearing a daily SPF  should be as much as a non-negotiable habit for all as putting on your pants in the morning, but if you’re talking roaccutane, it’s vital.

“Roaccutane makes the skin extremely sensitive to sunlight and it is far easier to get sunburnt whilst on treatment. Wearing SPF is an important part of looking after the skin.”

The sunscreens

Heliocare Advanced SPF 50 , £19

Antioxidant rich UV protection that brings down redness and helps to quell inflammation.

Avène Very High Protection SPF 50 , £13.50

Dry skin drinks up this vitamin E rich physical sunscreen.

Skinceuticals Sheer Mineral UV Defense , £36.75

A GTG team go-to all year round, this is possibly the crème de la crème of lightweight, fragrance-free mineral sunscreens. It works beautifully as a redness neutralizing primer too.

Jan Marini Physical Protectant SPF 45 , £43

With a universal tint to even out angry skin, broad spectrum UVA and UVB protection by way of physical filters and antioxidant green tea extract to defend against damaging free radicals, it’s no wonder this sun lotion is a dermatologist staple.

Rashes and reactions

“Skin rashes and  dermatitis  are a relatively common problem whilst taking roaccutane, particularly for those with a background or history of  eczema  and if the tablets are being taken during the cold winter months. It is best to speak to your dermatologist early should this develop, as topical steroid creams may be required for short periods of time to help to reduce reactivity.”

Hair and nails

“Hair thinning is a recognised but uncommon side effect of roaccutane that is likely to be dose-dependent i.e. it’s more likely to occur if you’re taking a high dose. It is often mild and can happen during a course of treatment but usually settles down within a few months of discontinuing the medication. Nail fragility, infection and ingrown nails have also been recognised with roaccutane, but again these are not common side-effects.

“The best way to look after the hair and nails is to follow a balanced diet rich in fruit and vegetables. If you’re at all concerned, speak to your dermatologist about any worries you may have. In some circumstances, taking a supplement such as biotin may be helpful if there is a suggestion of  a B vitamin deficiency . While biotin is not a proven treatment, taking it is unlikely to do any harm.”

Dermatologist Anne Wetter  also recommends adding a cuticle oil  into your regime if nails have become brittle.

Ingredients to avoid while taking roaccutane

“As the skin is extremely sensitive and fragile whilst taking roaccutane it is best to avoid products designed for oily or ageing skin. Ingredients to watch out for include retinoids , alpha and beta hydroxy acids  in addition to fragrance, essential oils and mechanical scrubs or exfoliators .”

Dr Wetter also cautions against the use of certain oils:

“Avoid potent skincare products in general, and I recommend being careful with vegetable oils, for instance, the likes of olive oil used on cracked skin. This can cause long-term contact dermatitis.”

Looking after your skin post-roaccutane

“Roaccutane usually works its way out of the system over a period of about 28 days after stopping treatment. Many people notice that, even after a week or so of stopping the medication, dryness starts to improve. Over this time the skin should become less sensitive and fragile and should return to what most would consider a “normal” state - not too dry and not too oily. It may not be necessary to use thicker or more hydrating moisturisers.

“Other agents can usually also be re-introduced, for example retinoids and AHAs/BHAs. I prescribe my patients  a topical retinoid  to use as a maintenance treatment at night after they complete their course of roaccutane. This helps to keep the skin clear of comedones and can also reduce any marks or scarring that the acne has caused.”

As skin is normally still delicate in the months after taking a course of roaccutane, Dr Wetter also warns against invasive treatments- wait until skin is fully recovered and always discuss any potential treatment plan with your doctor or dermatologist.

What is roaccutane, and how does it work?

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