Accutane Side Effects: A Nutritional & Integrative Approach

Rebecca Hunton, MD  |  Radiantly Healthy MD  |  Updated 2026

Accutane — or isotretinoin, as we call it medically — can be an incredibly effective treatment for persistent or severe acne. For someone who has struggled for years, tried multiple treatments, or is beginning to scar, it can make an enormous difference.

But effective medications can still ask a lot of the body. Dry lips and skin are among the most common Accutane side effects, and some people also notice dry eyes, changes in digestion, or simply that they don’t feel quite like themselves while taking it. We also monitor things like liver enzymes and triglycerides because those can change during treatment.

So when a patient asks me, “Is there anything I can do to support my body while I’m on Accutane?” my answer is absolutely yes.

Not because nutrition or supplements are going to replace the medication, and not because everyone needs an elaborate “Accutane protocol.” There are simply some sensible things we can do to make sure the rest of the body is well supported while the medication is doing its job.

First, a few things I want you to avoid

Before we talk about what to add, there is one important thing to take away: extra vitamin A.

Isotretinoin is a vitamin A derivative, so taking additional vitamin A supplements at the same time can increase the risk of side effects. This is one of those occasions when more is not better.

Examine your multivitamin, greens powder, and especially any supplement marketed for “skin, hair and nails.” Vitamin A can show up in places you might not expect it. Cod liver oil is another one to watch because, although it contains omega-3s, it can also contain substantial amounts of vitamin A.

That doesn’t mean you need to avoid carrots, sweet potatoes, leafy greens, or other foods naturally rich in carotenoids. We’re talking about avoiding unnecessary supplemental vitamin A.

And while we’re cleaning up the bathroom cabinet, this is also a good time to simplify your skin-care routine. Retinol, exfoliating acids, scrubs, and other aggressive products generally have no place on skin that is already becoming more sensitive and dry from isotretinoin. Gentle is your friend here.

Feed the skin from the inside, too

One of the things Accutane does very well is dramatically reduce sebum production. Unfortunately, your lips, skin, eyes, and nasal passages may suffer as a consequence.

This is where I like to make sure we have enough healthy fat in the diet, particularly omega-3 fatty acids.

Fatty fish such as salmon, sardines, and mackerel are wonderful sources. Chia, flax, hemp seeds, walnuts, avocado, and extra-virgin olive oil are easy additions as well. There is also some evidence that omega-3 supplementation may help with the dryness that accompanies isotretinoin, which fits nicely with what we often see clinically.

Ideally, you will need 4–6 servings of seafood a month. If that doesn’t appeal to the palate, I recommend a good-quality EPA/DHA supplement like our Pure Omega 1000. The goal isn’t to throw another pill into the mix simply because we can; it is to make sure the body has the fats it needs for healthy cell membranes, inflammatory balance, and skin-barrier function.

And don’t underestimate the very practical things. Use the moisturizer. Keep lip ointment everywhere — car, purse, desk, bedside table. If your eyes are getting dry, preservative-free lubricating drops can make a tremendous difference. A humidifier in the bedroom is surprisingly helpful for some people.

Dehydration will make all of this feel worse, so hydration matters. Your needs will vary with body size, activity, climate, and medications, and you may need considerably more fluid — and sometimes electrolytes — if you’re outside exercising in the Florida heat.

Sometimes the least glamorous recommendations are the ones you end up appreciating most.

What about the liver?

This is an area where I think we can bring a little common sense back into the conversation.

Yes, isotretinoin is metabolized by the liver, and it can affect liver enzymes and blood lipids, particularly triglycerides. That’s one reason your physician orders laboratory testing during treatment.

It does not automatically mean your liver is being “toxic” or that everyone on Accutane needs a detox. Our goal is a well-nourished liver with the raw materials it needs to do the enormous amount of work it does every day.

That means plenty of vegetables — especially cruciferous vegetables such as broccoli, cauliflower, Brussels sprouts, cabbage, and kale — along with leafy greens, colorful plants, adequate protein, and good hydration.

I also encourage people to be sensible about alcohol while taking isotretinoin. Your liver already has another job on its plate, and alcohol can also work against us if triglycerides are beginning to climb. Lots of sugar and refined carbohydrates can push triglycerides in the wrong direction as well, so this is a good time to pay attention to those rather than obsessing over dietary fat.

Supplements such as NAC, milk thistle, or glutathione support can be helpful, and I often recommend RHMD Detox — I take it daily just to support my liver.

And then there is the gut

There has been a lot written over the years about Accutane and inflammatory bowel disease, and understandably that has frightened some people. The larger body of research has been reassuring and has not shown an overall increased risk of inflammatory bowel disease with isotretinoin.

That doesn’t mean we ignore the gut.

Skin and gut health are connected in many ways, and good digestive health matters whether you’re taking Accutane or not. I want plenty of plant diversity and fiber, along with naturally fermented foods such as yogurt, kefir, sauerkraut, or kimchi if you tolerate them. Garlic, onions, asparagus, legumes, oats, and other prebiotic foods help create a healthy microbiome.

Don’t forget the basics your skin needs to repair

Acne makes us understandably focused on what is happening on the skin, but healthy skin is built from the inside.

Protein is particularly important. Your body needs amino acids to build and repair tissue, make enzymes and hormones, support immune function, and perform thousands of other jobs that are much more interesting to your physiology than counting calories.

When we are actively supporting healing and tissue repair, the standard RDA is simply not enough. I typically aim for 1.5–2 grams of protein per kilogram of body weight per day, depending on the individual. For a 150-pound person, that works out to roughly 100–135 grams of protein daily.

Collagen can also be a useful addition — typically 5–15 grams daily — but it complements rather than replaces complete dietary protein.

A few other things worth knowing

Sun sensitivity on isotretinoin is very real. Be diligent about sunscreen and don’t wait until you’ve had your first impressive sunburn to decide this advice was worthwhile.

Make sure to tell your physician if there is a meaningful change in mood, sleep, or mental health while taking it. The relationship between isotretinoin and depression has been studied extensively, and the data are far more reassuring than many people realize. In fact, clearing severe acne can have a profoundly positive effect on quality of life. Still, medicine is practiced one person at a time. If something changes significantly for you, it deserves a conversation.

So, what should you actually do while taking Accutane?

Eat real, nutrient-dense food. Get enough protein and healthy fat. Include omega-3-rich foods regularly. Hydrate well. Be kind to your skin rather than attacking it with more products. Avoid supplemental vitamin A. Go easy on alcohol and refined sugar, particularly if triglycerides are an issue. Pay attention to your digestion, your energy, your mood, and how you feel.

And get the appropriate laboratory monitoring.

Then let those things — not somebody’s generic internet protocol — tell us whether anything else needs to be added.

Accutane can be a remarkable tool for the right person. Supporting someone through treatment isn’t about choosing between the prescription and a more “natural” approach. It’s about using nutrition, lifestyle, thoughtful supplementation when appropriate, good monitoring, and the medication itself as parts of the same medical picture.

Because ultimately, we’re not treating an acne medication. We’re taking care of the person who’s taking it.

At Radiantly Healthy MD, we help patients through isotretinoin and other demanding treatments with nutrition, targeted supplements, and lab monitoring built around the individual. We would be glad to hear from you.

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