Supplements to Strictly Avoid While on Accutane
Isotretinoin (the generic name for Accutane) is a synthetic retinoid, meaning it is derived from vitamin A. While the medication is highly effective for acne, introducing excess vitamin A from other sources can cause serious side effects known as hypervitaminosis A.
Vitamin A Supplements
Never take additional vitamin A supplements in pill or liquid form. The risk of toxicity is significantly increased by combining the powerful synthetic retinoid with a concentrated, supplemental form of the vitamin. Common symptoms of vitamin A toxicity can include headaches, dizziness, nausea, vomiting, and dry, peeling skin, which can mimic or worsen typical Accutane side effects.
Multivitamins
Check the label of any multivitamin you currently take or plan to start. Many multivitamins contain high doses of vitamin A. It is best to choose a multivitamin that is either vitamin A-free or to stop taking it entirely while on Accutane. When checking ingredients, look for terms like retinyl palmitate, retinyl acetate, or beta-carotene. Your pharmacist can also confirm if a product is safe.
Fish Oil Supplements
Fish oil can contain significant amounts of vitamin A, especially if sourced from fish liver. Given this, it is safest to avoid all fish oil supplements during your treatment course unless your dermatologist gives explicit approval.
The Critical Need to Abstain from Alcohol
Combining Accutane and alcohol is strongly discouraged by medical professionals due to the significant and amplified strain both substances place on the liver.
Liver Stress and Damage
Both Accutane and alcohol are primarily metabolized by the liver. When consumed together, they can overload this organ, significantly increasing the risk of liver damage and toxicity. This can cause liver enzymes (which are monitored during your treatment) to elevate to dangerous levels.
Elevated Triglycerides
Accutane is known to increase blood fat levels, specifically triglycerides. Alcohol also raises triglycerides. When combined, this effect is amplified, which can lead to a dangerous and painful condition called pancreatitis, an inflammation of the pancreas. For this reason, regular blood tests are required to monitor lipid levels during Accutane therapy.
Mood and Side Effects
Alcohol is a depressant and can exacerbate potential mood-related side effects associated with Accutane. Furthermore, alcohol's dehydrating effect can intensify common Accutane side effects like dry skin, dry lips, and eye irritation. For the duration of your treatment, total abstinence is the safest and most recommended path.
Dietary Choices That May Support Your Treatment
While no specific foods are absolutely forbidden (aside from supplements and alcohol), some dietary adjustments can help minimize breakouts and support your overall health while on Accutane.
High Glycemic Index (GI) Foods
Some research links high GI foods, which cause rapid spikes in blood sugar, to acne breakouts. While Accutane is powerful enough to combat most causes of acne, limiting high GI foods may still be beneficial. Examples include:
- White bread, pasta, and rice
- Sugary drinks, including soda and fruit juice
- Certain starchy vegetables like white potatoes
Instead, focus on low GI options such as whole grains, legumes, and non-starchy vegetables.
Dairy Products
The link between dairy consumption and acne is debated and may be individual-specific. However, some patients find that reducing dairy, particularly skim milk, improves their skin's condition. If you suspect dairy is a trigger, discuss this with your dermatologist to see if a temporary reduction is appropriate. Always ensure you get enough calcium and vitamin D from other sources.
The Importance of Healthy Fats for Absorption
For many isotretinoin formulations, taking your dose with a fatty meal is not a recommendation but a necessity for proper absorption. Isotretinoin is a fat-soluble medication, and without fat, much of the drug passes through your system unused, making the treatment less effective.
To optimize absorption, your meal should contain a sufficient amount of healthy fat.
Here are some healthy fat sources to consider:
- Avocado
- Nuts and seeds
- Olive oil
- Fatty fish like salmon and tuna
- Full-fat dairy, such as whole milk or cheese (if dairy isn't a personal trigger)
- Peanut butter
Note that some newer isotretinoin formulas, such as Absorica and Absorica LD, are designed to be absorbed more efficiently and do not require a fatty meal. Always confirm with your dermatologist or pharmacist which specific product you are taking and follow their instructions.
Comparison of Dietary Considerations on Accutane
| Category | What to AVOID/LIMIT | What to PRIORITIZE |
|---|---|---|
| Supplements | Vitamin A supplements, multivitamins with vitamin A, cod liver oil, excessive fish oil | None (discuss with doctor), or supplements without added vitamin A |
| Beverages | Alcoholic beverages (beer, wine, spirits), excessive sugary drinks like soda and fruit juice | Water, herbal teas, decaffeinated drinks |
| Carbohydrates | High GI foods: White bread, pasta, sugary sweets, snack foods | Low GI foods: Whole grains, legumes, non-starchy vegetables |
| Fats | Excessive saturated and trans fats (deep-fried foods, high-fat meats) | Healthy fats (avocado, nuts, olive oil, fatty fish) to aid absorption |
| Dairy | Excessive dairy, particularly if it worsens acne symptoms for you | Dairy alternatives (almond milk, soy milk), low-fat dairy if tolerated |
Conclusion
While the list of forbidden foods on Accutane is relatively short, the restrictions regarding supplements and alcohol are non-negotiable for a safe and successful treatment. You must avoid all vitamin A supplements and alcoholic beverages to protect your liver and prevent serious complications. Beyond these essential rules, making sensible dietary choices can further support your skin's health, particularly by limiting high GI foods and managing dairy intake. For most Accutane formulations, remember to take your medication with a meal containing healthy fats for optimal absorption. Always communicate openly with your dermatologist about your diet and any questions you have. Your proactive approach to nutrition is a key component of a safe and effective Accutane journey.
