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A Dermatologist-Led Guide
Isotretinoin (commonly known by the brand name Roaccutane) is one of the most effective acne treatments available. It dramatically reduces activity of the sebaceous glands, normalises skin cell shedding, and decreases C. acnes bacteria — but its potency also means patients often look for ways to support their skin, energy levels, and overall wellbeing during therapy.
At Dermo Direct, we are frequently asked:
- “What supplements can I take while on isotretinoin?”
- “Are there vitamins that help with dryness or side effects?”
- “Which supplements should I avoid?”
As a Dermatologist – I often suggest that a lot of oral supplements are not needed whilst taking isotretinoin, as gentle skin care, emollient use and sunscreen/sun protection are the key focus areas for patients taking isotretinoin – but if patients are struggling with certain side effects, some of the following supplements can help.
Supplements are very commonly used these days, so a lot of patient are already taking supplements, and want to know if it is safe to continue them – so again this guide can help you filter out those that you should avoid whilst on isotretinoin.
Before You Start Any Supplement: A Safety Note
Isotretinoin is a fat-soluble retinoid, and combining it with certain supplements — especially vitamin A — can increase the risk of toxicity.
Always discuss new supplements with your dermatologist, especially if you take multiple products or if they include herbal “proprietary blends”.
Helpful Supplements While on Isotretinoin
1. Omega-3 Fatty Acids (Fish Oil)
Why it may help:
- Reduces inflammation
- Supports skin barrier function
- May help reduce dryness and cracked lips
- May improve mood and help counter the inflammatory triggers of acne
Evidence:
Several small studies show Omega-3s improve skin hydration and reduce trans-epidermal water loss — helpful when isotretinoin dries the skin.
Recommended dose:
Standard 1,000–2,000 mg daily EPA+DHA combined (avoid very high doses unless GP-supervised).
No known interaction with isotretinoin.
2. Probiotics
Why they may help:
Isotretinoin can alter mucous membranes and occasionally flare up gut sensitivity.
Probiotics may:
- Support gut comfort
- Reduce inflammation
- Help protect against antibiotic-related gut upset in patients recently on oral antibiotics for acne
3. Vitamin D
Many acne patients are vitamin D deficient, particularly during winter or if they avoid sun due to photosensitivity on isotretinoin.
Benefits:
- Supports immune function
- May help regulate inflammatory pathways
- Supports bone health (important for long courses)
Dose:
1,000 IU daily is typical; higher doses require GP supervision.
4. Zinc (but with caution on dose)
Why it may help:
- Anti-inflammatory
- Supports wound healing
- Can reduce skin irritation
Evidence:
Zinc gluconate has mild anti-acne properties and may assist with skin repair.
Dose:
≤ 25 mg elemental zinc daily to avoid nausea or copper depletion.
High doses offer no added benefit and may cause gut upset.
Supplements to Avoid While on Isotretinoin
1. Vitamin A
This is the most important supplements to avoid.
Why:
Isotretinoin is derived from vitamin A and combining the two increases the risk of hypervitaminosis A, which can cause:
- Headaches / pseudotumour cerebri
- Liver toxicity
- Nausea
- Bone pain
- Skin peeling
- Mood changes
Avoid:
- Vitamin A capsules
- Multivitamins containing high-dose retinol
- Cod liver oil (contains vitamin A)
Most multivitamins have Vitamin A with very low levels (<1,000 IU) – this is usually safe but unnecessary.
2. High-Dose Biotin (B7)
Often found in “hair, skin & nails” formulas.
Why avoid:
- Worsens acne in some patients
- Interferes with laboratory tests (thyroid, troponin, hormone tests)
- No benefit while on isotretinoin
Low dietary biotin is fine — avoid supplements >5,000 mcg.
3. High-Dose Vitamin E
Some websites claim vitamin E “protects the liver”, but high doses (>400 IU/day):
- Increase bleeding risk
- Have no evidence of reducing isotretinoin side effects
- May interact with other medications
Normal dietary intake is safe.
4. Herbal Supplements With Hormonal Effects
Avoid or use caution with:
- Saw palmetto
- DHEA
- Dong quai
- Black cohosh
Why:
They can affect hormones, liver pathways, or interact with medications.
5. St John’s Wort
Avoid completely.
Why:
- Strong enzyme inducer
- Can lower the effectiveness of other medications
- Mood-related shifts may overlap with isotretinoin monitoring
6. “Detox” Powders or Liver Cleanses
Often contain:
- High vitamin A
- Unknown herbs
- Diuretics
- Laxatives
These provide no benefit and may worsen dehydration or affect liver function tests.
Supplements That Are Safe – but may not be very helpful specifically to isotretinoin therapy
These supplements are commonly asked about but don’t help isotretinoin side effects:
- Collagen powders — fine, but won’t reduce dryness
- Protein powders — safe
- Magnesium — helps muscle cramps, not acne
- Vitamin C — safe, but no proven benefit
- Iron — only take if deficient
- Turmeric/curcumin — generally safe but may interact with blood thinners
Other topical therapies to help with isotretinoin side effects
These aren’t supplements but are extremely effective for managing dryness:
Urea-based moisturisers (5–10%)
Excellent for flaking or sensitivity.
Ceramide moisturisers
Replenish the natural skin barrier.
Nasal saline sprays
Helps with nose dryness and nosebleeds.
Lubricating eye drops
Crucial for contact lens wearers.
Lip balms with lanolin, petrolatum, ceramides
This is always needed with isotretinoin.
Disclaimer: The information in this article is for general informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you may have about your skin or general health. Individual results may vary.