Can I use other acne treatments while taking oral isotretinoin?

In general, oral isotretinoin is used only as a monotherapy, meaning that once you start oral isotretinoin you should stop all of your other acne treatments. It is well documented that when oral isotretinoin is taken in conjunction with the oral tetracycline class of antibiotics, there is an increase incidence in one of the side effects called pseudotumor cerebri. This feels like a really bad, persistent headache, along with nausea, vomiting, and problems with vision.

It should be brought to the attention of your doctor immediately. You should also not take vitamin A in high doses while on oral isotretinoin therapy because it is in the same class of compounds and the combination can increase the risk of toxicity. It is uncommon to prescribe other anti-acne medications with oral isotretinoin; however, some dermatologists co-prescribe a nontetracycline antibiotic such as erythromycin for the first month of therapy.

Because most topical acne treatments are at least somewhat drying or irritating, they should be discontinued within 1 month of starting oral isotretinoin treatment. Topical exfoliating agents, retinoids, and drying agents should be avoided because isotretinoin has a drying effect on the skin and mucous membranes.It is also helpful to avoid hot showers and drying soaps and to apply moisturizers several times during the day, especially after washing, to prevent dry, chapped skin. People who wear contacts may need to switch to soft lenses or eyeglasses until the dryness resolves.

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