How can I reverse the effects of oral isotretinoin (Accutane) on triglyceride levels and potential liver damage?

Doctor's Answers 1

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Dr Wai Leong Quan

Gastroenterologist

Oral isotretinoin is known to induce side effects in some people despite only being taken for a short period of time. Besides skin dryness, triglyceride (TG) and liver enzyme elevations are the commonest biochemical changes expected in the blood.

The skin specialists who prescribe isotretinoin will usually monitor the TG and liver function of their patients on a regular basis. Mild elevation of these blood markers does not require any intervention. This is because the treatment duration usually last only 3-6 months. Once treatment ends, the elevated TG and liver enzymes should normalise. No long-term harm to the liver is expected.

In the rare occasion when elevations are more than 3-5x upper limit normal, most doctors will either adjust the dose of isotretinoin or switch medicine to prevent further uncontrolled elevation of these markers. Medicine to lower the TG may also be implemented at times if the isotretinoin treatment cannot be stopped immediately.

It will be prudent to ensure all abnormal results are back to baseline when the treatment stops. Persistent elevation post-treatment should prompt further investigations to rule out other undiagnosed conditions.

Similar Questions

Can I undergo fractional C02 or Infini treatment while on low dose Isotretinoin?

Sorry to hear that you are suffering from acne scars. Low dose isotretinoin (Accutane) is increasingly being used for acne. Many patients on isotretinoin also have scarring from previous acne. It is best to start scarring treatment early, but there remains some concern with abnormal scarring while on isotretinoin. Can you undergo fractional CO2 or Infini treatment while on low dose Isotretinoin? It is safe to proceed with fractional CO2 laser or radiofrequency microneedling while on low dose Isotretinoin.

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Answered By

Dr Wan Chee Kwang

Aesthetic

How safe is low dose Accutane/Isotretinoin in the long term?

It is good to hear that you have achieved good control of acne with isotretinoin. The low dose that you are taking now will reduce sebum (oil) production and maintain your condition. From research studies done on adults, low dose isotretinoin showed no side effects to the body when the researchers did an extensive panel of blood tests on patients who took isotretinoin 20mg twice a week for 3 years. Your dose is even lower than this so it is safe, provided that you do not have habits such as excessive alcohol intake, as that will stress your liver.

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