Significant hair thinning from Accutane, should I stop?

Hello and thank you for your question. Yes, it is possible to have thinning from Accutane but the chances are small. It's difficult to tell the cause of the thinning without seeing you so I suggest you see your doctor and have some tests done to see what's going on. Best of luck to you.

Dr. T

About 1 in 20 patients who use isotretinoin (Accutane) experience hair loss. The risk is dose dependent - with patients using higher doses ( 0.5 mg per kg ) have a nearly two fold higher chance of hair loss than those using less than 0.5 mg per kg. All in all about 3-6 % of isotretinoin (accutane) users have shedding.

Now, whether to stop or not is an entirely different story, I can’t answer this without knowing alot more about your story. If you have recently had COVID infection, influenza, lost weight , been under high stress, or developed abnormalities in your blood tests like low thyroid levels or low iron levels then isotretinoin may not even be the cause. Be sure to have all of these factors evaluated if you have not already.

If you have mild acne, then stopping or even reducing the dose could make sense if isotretinoin is 100 % felt to be the cause. However, if you have acne that is causing scarring on the face or body, then this is not so simple of a question, For mild acne, there may be many other options besides isotretinoin. However, for severe scarring forms of isotretinoin, there are not many options as good ad isotretinoin to prevent or halt the potential for permanent lifelong scars on the skin of the face or body. So it all comes down to first being clear on the cause of shedding and then figuring out through discussion with your dermatologist whether permanent scarring is likely with your form of acne. If there is actually high chance of scarring then continuing or reducing the dose slightly could be a preferable option for many people.