Man recounts debilitating joint pain after acne drug, says warnings were missing

Kyle Frank, a 28-year-old London-based entrepreneur, says isotretinoin—an acne drug prescribed for severe, treatment-resistant cases—transformed his skin but delivered a drastic, painful side effect. Within about two weeks of starting the medication, he woke up unable to move as his joints and muscles grew so stiff. 'I had signed a paper listing side-effects, but I was never told that joint pain could be an issue,' he says. 'I wish someone had warned me.'

Frank's acne began erupting when he was 17, and over five years he cycled through topical products and a string of prescription medications that offered only brief improvements. He developed dermatitis and rosacea, with visibly damaged capillaries on his nose and cheeks. 'I went into a shopping centre to speak with skin specialists and they told me that it was because the capillaries, or blood vessels, in my skin were damaged—something that typically happens in old age,' he recalls. As a last resort, at 19 his dermatologist prescribed isotretinoin after other treatments failed to deliver lasting results. Within two weeks, the joint pain intensified: 'I woke up and could barely move or walk,' he says. 'I'm usually quite an active person, but I couldn't do anything. It was like I had been in a road-traffic accident.'

Shortly after the onset of the symptoms, Frank stopped isotretinoin after about seven weeks. 'Within a few days, my stiffness improved and I began to feel better,' he says. 'But I still feel the lasting impact today, occasionally dealing with joint issues.' He notes that his doctor never mentioned the possibility of joint pain as a side effect, and he worries about others who might be blindsided by similar adverse effects.

Isotretinoin, sold under the brand name Roaccutane in some markets, was first licensed in 1983 and remains prescribed to tens of thousands in the UK each year for severe acne resistant to other treatments. The drug works by suppressing skin oil production, reducing acne-causing bacteria. Since its approval, isotretinoin has generated more than 8,000 adverse-effect reports to the Medicines and Healthcare products Regulatory Agency (MHRA), including joint and muscle pain, vision problems, anaemia, seizures and mood changes. The drug can cause dry skin, rashes, headaches and back pain; rare cases include liver damage; and women are advised not to conceive while on treatment due to birth-defect risks. The medication is typically prescribed only by dermatologists because of its potential risks.

Campaigners have pressed for tighter controls or bans in the wake of severe side effects. A three-year government medical watchdog review published in 2023 found that isotretinoin's benefits outweigh its risks for most patients. Some studies have found similar levels of mental-health concerns in acne patients treated with Roaccutane versus those treated with antibiotics or other strong therapies, suggesting no clear evidence that isotretinoin uniquely harms mental health compared with alternatives. For Frank, the experience remains a hard lesson. 'I acknowledge I may be an outlier in the severity of my side-effects, but I hope others realize isotretinoin isn't the only option and that more attention should be given to informed consent and monitoring,' he says. He also cautions that social media chatter, including videos suggesting cosmetic motives for treatment, can mislead young people into seeking prescriptions for inappropriate reasons.

Roche, the Roaccutane's manufacturer, said in a brief statement that safety is taken seriously and that millions have taken the drug, but like most medications, it can have side-effects. It stressed that patients should be fully informed about what to expect and be monitored closely to ensure ongoing care.