Accutane is commonly referred to as the brand name for Isotretinoin, which is a medication made from vitamin A.[1] It belongs to a category of medications called retinoids. Retinoids are used to slow down oil production in the skin, shrink the size of the glands that create oil in the skin, and alter how skin cells grow and die.[2]
These properties help reduce the amount of oil produced by these glands, making it ideal for treating severe acne and chronic lesions that have failed to respond to alternative treatments. As a result of being a strong medication, it also includes several precautions, including a high risk of producing birth defects in infants born to pregnant women taking Isotretinoin.[3] Pregnant women are closely monitored with respect to using Accutane.
There are many questions from patients regarding the dangers of consuming alcohol while on Accutane.
Generally speaking, most doctors advise against consuming alcohol while on Accutane. The liver processes both alcohol and Isotretinoin in similar ways. Both require processing via the same pathways within the liver, which means the liver is forced to handle twice the workload it would normally encounter. For these reasons, standard blood testing occurs routinely as part of every Accutane treatment plan.
However, there are exceptions to this rule. Certain factors, such as normal liver enzyme levels, absence of any prior liver illness or dysfunction, and an assessment from the patient’s doctor, will determine how cautious a doctor needs to be. For example, individuals with normal liver functions and no prior medical history may receive more liberal guidelines than those with elevated triglyceride levels or medical histories of liver dysfunction. Due to this fact alone, relying on general internet suggestions is inadequate, and relying on the assessment from the patient’s doctor or healthcare team managing laboratory test results is the best route.
Alcohol combined with Accutane puts additional strain on the liver:[4]
Low-dose Accutane combined with alcohol affects risk differently than high-dose Accutane. Although it is possible that low-dose Isotretinoin may have fewer side effects compared to high-dose versions, drinking alcohol can still potentially elevate lipid levels caused by Isotretinoin.[5] Combining drinking with low-dose Isotretinoin creates uncertainty with regard to determining which source is responsible for elevated lipids.
It appears as though dehydration caused by alcohol adds to the dryness of lips, skin, and eyes that most patients experience as a result of taking Accutane. [6] Fatigue and headaches appear to be exacerbated by drinking as well.
In most cases, having one drink unintentionally while taking Accutane will not necessarily halt or undo your treatment progress. However, most dermatological practices follow these steps:
Abstaining from drinking alcohol entirely is recommended for the duration of treatment for patients who:[7]
Most physicians recommend waiting until after your treatment has concluded and all remaining laboratory results have returned to normal before returning to your normal drinking habits. Isotretinoin has a half-life, or the length of time it takes for the amount of the active component in your system to drop by half.
Waiting until your physician indicates that treatment is completed, and reviewing any existing laboratory results obtained during treatment, will provide you with the safest option for returning to your normal drinking patterns.
While there are several small actions you can perform each day to maintain better health while undergoing Accutane therapy, virtually all are simple habits that can be incorporated into your daily routine and may assist in preventing other health issues along the way.
Your experiences with Isotretinoin may serve as a valuable opportunity to assess your past experiences with drinking behaviors, beyond simply evaluating potential interactions between Isotretinoin and alcohol. Mood changes have also been reported among some patients receiving Isotretinoin, so your physician will monitor your mental health throughout your treatment.[8] Drinking may influence moods as well, and when taken together, may interfere with distinguishing which influences your feelings.
If you find yourself experiencing difficulty controlling when and how much you choose to drink, please discuss this issue with your physician, not merely as it relates to your treatment. Commonly, questions are raised with regard to alcoholism, substance abuse, and addiction, and various forms of treatment and detoxification programs are available to support families and patients struggling with addiction, substance dependency, or abuse, separately from any skin treatments being administered.
You should contact your physician for guidance if you consistently drink large quantities of beverages containing alcohol, develop abnormal laboratory results, suffer from side effects that cannot be managed appropriately, possess a history of liver disease, or are uncertain whether continuing treatment is advisable. Every decision regarding the safety and appropriateness of continued treatment with Isotretinoin should be based upon an evaluation specific to the individual patient, and not simply based upon generalizations offered over the internet.
One drink is highly unlikely to disrupt treatment progress on its own. More importantly, it is your overall pattern of behavior, whether you frequently consume larger volumes of alcoholic beverages (binge drinking), and whether this drinking negatively affects your laboratory results, that is of greater concern.[9]
Ultimately, it is not specifically the type of beverage that poses a risk. All types of alcoholic beverages pose risks because they all negatively affect your liver function.[10] So changing which beverage type you prefer, such as switching from wine to beer or vice versa, does not greatly lower the risks associated with alcohol consumption while on Accutane.
Drinking can promote inflammation and dehydration, both of which can negatively affect how your skin appears and feels, independently of any topical or oral acne treatment.
Missing or adjusting your doses without consultation with your physician is never acceptable. Any questions related to dosage timing surrounding your use of alcohol should be discussed with your physician exclusively.
Most physicians recommend waiting until your physician advises that treatment has concluded successfully and any outstanding abnormal laboratory results have resolved before you resume your usual drinking habits.
[1][5][8] Roche Laboratories Inc. (2002). Accutane (isotretinoin) capsules: Prescribing information. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/18662s051lbl.pdf
[2] Shalita, A., & Del Rosso, J. (2024). Isotretinoin. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK525949/
[3][6] American Academy of Dermatology Association. (n.d.). Isotretinoin: The truth about side effects. https://www.aad.org/public/diseases/acne/derm-treat/isotretinoin/side-effects
[4] National Institute of Diabetes and Digestive and Kidney Diseases. (2020). Isotretinoin. LiverTox: Clinical and research information on drug-induced liver injury. https://www.ncbi.nlm.nih.gov/books/NBK547857/
[7][9][10] National Institute on Alcohol Abuse and Alcoholism. (n.d.). Alcohol’s effects on the body. National Institutes of Health. https://www.niaaa.nih.gov/alcohols-effects-health/alcohols-effects-body
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