Isotretinoin linked to debilitating joint pain, patient says warning was missing

A London entrepreneur says isotretinoin, a prescription acne drug, left him with debilitating joint pain that doctors never warned him could happen. Kyle Frank, 28, had struggled with acne since his teens. After years of failed over-the-counter remedies and a string of prescriptions that did little to help, he was told by a dermatologist that isotretinoin might be his last resort for severe, scarring acne. "No one in my family had ever suffered with acne, so I didn't know what to do," he said. By his late teens, his cheeks were peppered with angry red spots and painful nodules, and he felt his options had narrowed to aggressive treatment or letting the condition run its course.

After five years of trying various topical and ingestible medications, Frank says a formal diagnosis of dermatitis and rosacea followed by a pivotal prescription changed his life in an instant. Within two weeks of starting isotretinoin, he says he woke up unable to move. "I woke up and could barely move or walk," he recalled. "It felt like I had been in a road-traffic accident." He describes his joints as painfully stiff, and his daily routine as suddenly impossible. He stopped the drug after seven weeks, but the damage, he says, did not disappear overnight. "My joints hurt and were so stiff, I couldn't even get up, let alone go out of the house," he recalled. "It was like I had a tin man inside me."

He stopped isotretinoin and shifted to what he describes as more natural remedies, reporting that his skin gradually improved. But he still lives with occasional joint inflammation years later. "I felt like the life was being sucked out of me," he said. "If I knew, I would never have taken it, given that I still have inflammation and pain in my knees and hips today." Despite the lingering effects, Frank has gone on to found his own skincare brand, Frank's Remedies, using ingredients he says helped soothe his skin when other treatments failed. "I was only on it for a relatively short time and I've been left with lasting pain. Imagine the damage it could have done if I'd stayed on it," he said."

Isotretinoin, marketed in the United Kingdom for decades under the brand Roaccutane, was first licensed in 1983 and remains prescribed to tens of thousands of patients each year. In the UK, the drug is reserved for severe acne that resists other treatments or that might cause permanent scarring. Since its approval, the Medicines and Healthcare products Regulatory Agency (MHRA) has logged more than 8,000 reports of adverse effects linked to isotretinoin, ranging from vision problems and anemia to joint and muscle pain and even seizures. The drug works by reducing the skin’s oil production, which acne-causing bacteria feed on, and studies have shown many patients’ skin clears within four months. For some, however, the potential downsides can be severe and include excessively dry skin, rashes, headaches, back pain and, in rare cases, liver damage. There are also warnings about mood changes and a risk of birth defects if used during pregnancy.

In Kyle’s case, the joint pain is a rare but documented side effect. Medical histories for isotretinoin describe a spectrum of musculoskeletal complaints, including inflammatory changes in the joints and surrounding tissues. The broader medical landscape notes that while the drug can be transformative for persistent acne, its safety profile requires careful monitoring and patient education. Kyle says his doctors did discuss possible side effects, but he insists that joint pain was never mentioned as a potential risk. "If I had known, I would have reconsidered taking it," he said. "I wish someone had warned me."

The drug’s manufacturer, Roche, said in a statement that safety is a priority for all medicines. "We take the safety of all our medicines very seriously. Millions of patients worldwide have taken Roaccutane, but like most medications, it can have side-effects. It is vital that patients are fully informed as to what to expect when they take it and that they are monitored closely to ensure they get the ongoing care they need," the company said.

Regulatory and research authorities have weighed the drug’s benefits against its risks in recent years. A three-year government medical watchdog review in 2023 concluded that isotretinoin’s benefits outweighed its risks for severe acne that fails to respond to other treatments. Some studies comparing mental-health outcomes in acne patients taking Roaccutane versus those on antibiotics have found no consistent difference in levels of mental ill health between the groups. Nevertheless, mood changes and, in rare cases, suicidality have been reported, underscoring the need for careful monitoring, especially in younger patients.

Kyle acknowledges that he may be an outlier in terms of the severity of his side effects, but he hopes his story informs other young people considering isotretinoin that there are viable alternatives. He notes that social media has sometimes magnified perceptions of isotretinoin, including online rumors about facial changes or other cosmetic effects that do not reflect typical experiences. "When I was thinking about starting isotretinoin, I remember looking on TikTok and seeing so many videos of young people saying it could give them a slimmer nose because of its drying effect on the body," he said. "There were people asking how to be prescribed it without having acne, because they wanted to change their face, rather than clear up their skin."

After leaving isotretinoin, Frank began to rebuild his skin barrier and shifted toward less aggressive approaches. He says his skin improved as he reduced stress and focused on restoring balance, and he ultimately turned his experience into a business aimed at helping others with stubborn breakouts.

Experts caution that isotretinoin remains a powerful option for people with severe acne, but they stress the importance of informed consent and ongoing monitoring. For Kyle, the takeaway is clear: while the drug can be life-changing for some, it carries potential risks that should be openly discussed, and patients should feel empowered to evaluate alternatives if side effects arise. "If I had known the potential for joint pain, I would have weighed my options more carefully and asked more questions before starting treatment," he said. He now encourages others to seek comprehensive care and to consider all available options before choosing a path that may carry lasting consequences.