Isotretinoin gel (Isotrex)

  1. About isotretinoin gel

    Isotretinoin gel is an effective treatment for mild to moderate acne (spots).

    It can be used on its own or with other creams, gels or antibiotic tablets.

  2. Key facts

    • Isotretinoin gel takes 6 to 8 weeks to work.
    • The most common side effects of isotretinoin gel are red, sore or dry skin and lips. These side effects go away when you stop the treatment.
    • If you're a woman, it's really important not to become pregnant while using isotretinoin gel and for at least 1 month after stopping. Isotretinoin can harm an unborn baby.
    • Isotretinoin gel can make your skin sensitive to sunlight. For safety, stay out of bright sun and use a high factor sun cream even on cloudy days.
    • The brand name for isotretinoin gel is Isotrex.
  3. Who can and can't use isotretinoin gel

    Isotretinoin gel is for teenagers and adults with mild to moderate acne.

    Don't use isotretinoin gel in children under the age of 12 or before puberty.

    Isotretinoin gel may not be suitable for some people. Tell your doctor before starting treatment if you:

    • have had an allergic reaction to isotretinoin or any other medicines in the past
    • get eczema
    • have had skin cancer
    • are pregnant or think you could be pregnant, or you're breastfeeding

    Don't use isotretinoin gel if you're pregnant or think you might be pregnant, or you're breastfeeding.

  4. Side effects

    Like all medicines, isotretinoin gel can cause side effects, although not everyone gets them. Side effects will usually go away when you stop using the gel.

    Common side effects

    Common side effects of isotretinoin gel happen in more than 100 people. Talk to your doctor or pharmacist if these side effects bother you or don’t go away.

    • dry skin
    • red or peeling skin
    • skin irritation or itching
    • skin becoming more sensitive to sunlight

    Serious side effects

    Sometimes these skin reactions can be more severe. If you have severe burning, peeling, redness or itchiness of your skin, stop using the gel and see a doctor straight away.

    Serious allergic reaction

    In rare cases, it’s possible to have a serious allergic reaction to isotretinoin.

    A serious allergic reaction is an emergency. Contact a doctor straight away if you think you or someone around you is having a serious allergic reaction.

    The warning signs of a serious allergic reaction are:

    • getting a skin rash that may include itchy, red, swollen, blistered or peeling skin
    • wheezing
    • tightness in the chest or throat
    • having trouble breathing or talking
    • unusual hoarseness
    • swelling of the mouth, face, lips, tongue, or throat

    These are not all the side effects of isotretinoin gel. For a full list see the leaflet inside your medicines packet.

    You can report any suspected side effect to the UK safety scheme.

  5. How to cope with side effects

    What to do about:

    • dry skin or lips – apply a moisturiser and lip balm regularly (the best type of moisturiser is an oil-free face moisturiser for sensitive skin) and try to keep your showers shorter than 2 minutes, using lukewarm water rather than hot
    • skin irritation or pain – try using the gel less often (maybe once a day instead of twice, or every other day), or you could stop using the gel for a few days until the irritation goes away and then try using it again. If the irritation doesn't go away, stop using the gel and speak to your doctor
    • your skin becoming sensitive to sunlight – stay out of bright sun and use a high factor oil-free sun cream (SPF 15 or above) even on cloudy days; don't use a sunlamp or sunbeds
  6. How to use the gel

    Apply isotretinoin gel once or twice a day as instructed by your doctor.

    Always wash and dry your skin, and completely remove any make-up, before you apply the gel. This will help it work better.

    Put a thin layer of the gel on the affected skin using your fingertips and smooth it in. Apply it to all areas of skin that have acne and not just each spot.

    You only need to apply a thin layer of gel. Try not to use too much, especially where the gel could run into your eyes or build up in folds of skin. Using more gel will not make your spots clear up more quickly.

    Don't apply isotretinoin gel to irritated areas of skin – for example, cuts, burns or sunburn – as it can make the irritation worse.

    Only ever use isotretinoin gel on your skin, and keep it away from your mouth, lips and eyes.

    What if I forget to take it?

    If you forget to apply the gel, skip the missed dose and apply the next dose at the usual time.

    Never apply a double dose. Never apply an extra dose to make up for a missed one.

    If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

    What if I use too much?

    If you use too much isotretinoin gel or use it more often than you should, it may make your skin red or irritated. If this happens, use the gel less often or stop using it for a few days.

    Will the amount I take go up or down?

    The dose of isotretinoin gel will probably not change, although if your skin becomes irritated, your doctor may suggest you use it less often for a while.

  7. Advice for women

    • This medicine is likely to harm a baby.
    • Use reliable contraception to prevent pregnancy while you're using isotretinoin gel – some brands of contraception pill can help with acne.
    • If you become pregnant during treatment with isotretinoin gel, stop using it and talk to your doctor straight away.
    • Don't breastfeed while you're using isotretinoin gel. This medicine can get into breast milk and harm your baby. 

    Do not use isotretinoin gel if you're pregnant or think you're pregnant. This medicine can harm a baby.

  8. Cautions with other medicines

    Some medicines and isotretinoin gel can interfere with each other and make it more likely that you'll have side effects.

    Tell your doctor if you're taking these medicines before you start isotretinoin gel:

    • other acne medicines – using both together may make skin irritation worse
    • benzoyl peroxide cream or gel (another acne treatment) – it may make isotretinoin gel less effective

    Mixing isotretinoin gel with herbal remedies and supplements

    There's very little information about taking herbal remedies and supplements while you use isotretinoin gel.

    However, for safety, tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies and supplements.

  9. Common questions

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