Accutane lips: why they dry out and what helps

Dry, cracked lips are one of the most common side effects of isotretinoin, the drug many people still call Accutane. The American Academy of Dermatology (AAD) includes lip care in the skin care plan it recommends for everyone taking the drug. This guide explains why the lips dry out, how often it happens, what the AAD suggests, and the signs that mean a call to your prescriber. For the drug itself, see the Accutane guide.

Skinli gives general education and is not a doctor. Isotretinoin is prescribed and monitored by a doctor, who asks about dryness at each monthly visit. Tell them how your lips are doing, even if it seems minor. If you are still deciding whether to see someone about severe acne, read when to see a dermatologist for severe acne.

Why isotretinoin dries the lips

Isotretinoin works on acne by shrinking the oil glands in the skin. The FDA label says the drop in oil reflects a reduction in the size of these glands, and that the effect is temporary.

The older Accutane label explains the pattern in one line: many of the drug's side effects are like those seen in people who take large doses of vitamin A, including dryness of the skin and the moist linings of the lips, nose and eyes. Isotretinoin is closely related to vitamin A, which is why the label also tells patients to avoid vitamin A supplements during treatment.

The label says the lip inflammation, called cheilitis, is linked to dose. A higher daily dose tends to dry the lips more. Your prescriber chooses the dose, and the label says it may be adjusted during treatment for side effects.

How common it is

The August 2026 FDA label lists dry lips, chapped lips and cheilitis among the side effects seen in 5 percent or more of patients. A 2022 review pooled 30 trials with 3,274 patients to count how often each side effect was reported:

Side effect	Share of patients who reported it
Dry lips	58.2 percent
Dry skin	49.1 percent
Cracked, inflamed lips (cheilitis)	41.5 percent
Dry nose	40.2 percent
Dry or irritated eyes	26.9 percent
Nosebleeds	23.8 percent

Each figure is the share of patients with that effect among the trials that reported it. The trials used different doses, so your own experience may differ.

What dermatologists suggest for the lips

The AAD's page on isotretinoin side effects gives these steps:

• Outdoors: use a lip balm with SPF 30 or higher. The AAD says isotretinoin can make skin more sensitive to the sun.
• Indoors: apply petroleum jelly to the lips throughout the day and before bed, to help them stay moist.

A simple day can follow that pattern:

1. Morning: after washing your face, apply lip balm with SPF 30 or higher.
2. During the day: reapply the lip balm when you are outside, and keep petroleum jelly with you for indoors.
3. Evening: apply a layer of petroleum jelly before bed.

The AAD lists ingredients to avoid while taking isotretinoin: retinol, exfoliating acids such as glycolic, lactic and salicylic acid, scrubs, fragrances and dyes. Keep them off your lips as well as your face.

The nose and nosebleeds

The inside of the nose dries out in the same way, and the FDA label lists nosebleeds among the most common side effects. The AAD says treating dryness inside the nose as soon as you notice it can prevent or reduce nosebleeds. It suggests a moisturizing nasal spray, or a small amount of petroleum jelly just inside the nostril. It warns not to sniff or inhale the jelly, and suggests the type in a squeeze tube so you are less likely to put germs from a jar into your nose.

The older label's Medication Guide says to call your doctor about any side effect that bothers you or does not go away, and frequent nosebleeds fit that description.

Dry eyes and contact lenses

The AAD suggests saline eye drops or artificial tears for dry, irritated eyes, and says to use medicated eye drops only if your dermatologist recommends them. The FDA label says people who wear contact lenses may have trouble wearing them during treatment and afterwards. The Medication Guide says to stop the drug and call your prescriber for any change in vision, or for eye dryness that is painful or constant. Sunglasses with UV protection can make dry eyes feel more comfortable outdoors, the AAD says.

Dry skin on the face and body

The rest of the skin dries too. The AAD's four-step plan is a gentle cleanser no more than twice a day and after sweating, an oil-free moisturizer on damp skin, a broad-spectrum SPF 30 or higher sunscreen outdoors, and lip balm or petroleum jelly for the lips. It says the same care applies to the body, and that the products do not need to be expensive. Look for hydrating ingredients such as glycerin, hyaluronic acid or ceramides on the label. The NHS also says not to use products with salicylic acid or benzoyl peroxide during treatment.

Hands, feet and nails

The dryness can affect the hands, feet and nails too. MedlinePlus lists peeling skin on the palms of the hands and the soles of the feet, and changes in the nails, among the side effects to report if they are severe or do not go away. The FDA label also lists fragile skin and bruising. Ask your prescriber what to use on these areas, and mention any cracks that do not heal.

Sun protection for lips and skin

The FDA label tells patients to avoid long exposure to sunlight and ultraviolet light, and the Medication Guide says tanning machines use ultraviolet light. The AAD says you can sunburn quickly and unexpectedly while taking isotretinoin, and it recommends:

• Seeking shade, and wearing a wide-brimmed hat, long sleeves and pants.
• A non-comedogenic sunscreen, meaning one that will not clog pores, with SPF 30 or higher, broad-spectrum protection and water resistance.
• A mineral sunscreen with zinc oxide, titanium dioxide or both, if your skin feels sensitive.
• Reapplying at least every 2 hours, and after swimming or sweating.

The lips need the same care, which is why the AAD's lip balm advice includes SPF 30 or higher outdoors.

Waxing near the lips

Upper-lip waxing needs to wait. The FDA label says to avoid waxing and skin resurfacing procedures, such as dermabrasion and laser, during treatment and for at least 6 months after, because of a possible risk of scarring. The AAD says the rule applies to hot wax and cold wax. Ask your dermatologist before any hair removal or cosmetic treatment on the face during that time.

Questions for your monthly visit

Bring these to the check-in if your lips are a problem:

• Is the amount of dryness I have expected at my dose?
• Which lip products do you recommend, and is there anything I should stop using?
• My lips are cracking or bleeding. Do I need a prescription product?
• Is this swelling or rash something that needs a closer look?

When dry lips need a doctor

Most lip dryness is uncomfortable and manageable. Call your prescriber if you notice:

• Swelling that is new or growing. The Medication Guide lists swelling of the lips among the common side effects. It also says to stop the drug and get emergency help right away for hives, a swollen face or mouth, or trouble breathing, which can be a serious allergic reaction.
• Cracks that bleed, weep or look infected. The FDA label lists infections among the side effects, including herpes simplex, the virus behind cold sores. MedlinePlus lists slowed healing of cuts or sores.
• Sores in the mouth with a rash, fever or blisters. The Medication Guide says these can be signs of a serious skin reaction and to stop the drug and call right away.
• Lips so sore that you are thinking of stopping. Tell your prescriber instead of stopping on your own. The dose and the care plan are theirs to adjust.

After treatment

The AAD says the dryness clears once you stop taking isotretinoin. The FDA label says most side effects in trials reversed when the drug was stopped.

For the full list of what to watch for, see the Accutane side effects guide. For hair and weight changes, see Accutane, hair loss and weight. The how long Accutane takes to work guide explains the timeline the dryness runs alongside.