From the Guidelines
Isotretinoin (Accutane) is not commonly associated with hyperhidrosis as a side effect, and there is no strong evidence to support this claim in the provided guidelines of care for the management of acne vulgaris 1. The guidelines strongly recommend oral isotretinoin for acne that is severe, causing psychosocial burden or scarring, or failing standard oral or topical therapy, without mentioning hyperhidrosis as a potential side effect. Key points to consider when prescribing isotretinoin include:
- The medication is effective in reducing oil production in the skin and can improve acne symptoms
- Common side effects include dry skin, lips, and eyes, but hyperhidrosis is not typically reported
- The recommended dosage of isotretinoin typically ranges from 0.5 to 1 mg/kg/day for 15-20 weeks, as determined by the patient's response and tolerance to the medication 1. If a patient experiences excessive sweating while taking Accutane, it is essential to stay hydrated and inform their dermatologist, who may choose to continue the medication, adjust the dosage, or reevaluate the treatment plan based on the individual's response and quality of life.
From the FDA Drug Label
Respiratory Bronchospasms (with or without a history of asthma), respiratory infection, voice alteration (which in some cases persists) bruising, cheilitis (dry lips), dry mouth, dry nose, dry skin, epistaxis, eruptive xanthomas,7 erythema multiforme, flushing, fragility of skin, hair abnormalities, hirsutism, hyperpigmentation and hypopigmentation, infections (including disseminated herpes simplex), nail dystrophy, paronychia, peeling of palms and soles, photoallergic/photosensitizing reactions, pruritus, pyogenic granuloma, rash (including facial erythema, seborrhea, and eczema), Stevens-Johnson syndrome, sunburn susceptibility increased, sweating, toxic epidermal necrolysis, urticaria, vasculitis (including Wegener's granulomatosis; see PRECAUTIONS, Hypersensitivity), abnormal wound healing (delayed healing or exuberant granulation tissue with crusting; see PRECAUTIONS, Information for Patients)
Isotretinoin (Accutane) can cause hyperhidrosis, as indicated by the presence of sweating in the list of adverse reactions 2.
From the Research
Isotretinoin and Hyperhidrosis
- Isotretinoin, also known as Accutane, is a medication used to treat severe acne.
- There is limited evidence directly linking isotretinoin to hyperhidrosis.
- A study from 2023 3 found that one of the oral isotretinoin brands, Isosupra®, had a reported side effect of excessive sweating (4.1%) in patients being treated for acne.
- However, this study did not establish a direct causal relationship between isotretinoin and hyperhidrosis.
- Other studies, such as those from 1983 4, 2018 5, 2006 6, and 2005 7, did not mention hyperhidrosis as a side effect of isotretinoin.
- These studies did report various other side effects, including mucocutaneous effects, xerosis, and cheilitis, but hyperhidrosis was not specifically mentioned.