Continuous flaky skin even after moisturising?

Question

I am currently on 50mg of Accutane and I am continuously getting flaky skin. I moisturise all the time but about 10 minutes later, I have more flaky skin. What can I do to get rid of this; is there any recommended moisturisers ( using cetaphil moisturiser at the moment). Also, I have had eczema but it has gotten significantly worse on my arms and neck, is there anything to help this ( I have been using dermol cream a lot). Thanks

Anna Chacon, MD, FAAD · Answer

Thank you for sharing these details. What you’re experiencing is unfortunately very common while on a 50mg dose of Accutane. The medication works by drastically reducing oil production in your skin, which helps with acne but also leaves your skin very dry and prone to flaking—even if you’re moisturizing frequently.

A few things can help:

Layering Moisturizers: Instead of relying on just one, try a combination of a lightweight, hydrating moisturizer and a thicker occlusive (like petrolatum or Aquaphor) on top. The first draws water into your skin, and the occlusive seals it in to prevent moisture from evaporating.

Moisturizing Immediately After Washing: Apply moisturizer within 2–3 minutes of washing your face or showering. This locks in whatever moisture is present.

Gentle Cleansing: Use lukewarm water and avoid harsh soaps or foaming cleansers, as they can strip the little oil your skin still produces. Cetaphil is good, but make sure it’s the gentle, non-foaming version if possible.

Targeting Flare Areas: For areas affected by eczema, like your arms and neck, thicker emollients like CeraVe Healing Ointment, Aquaphor, or even plain petrolatum may be more effective than Dermol cream. Apply multiple times a day as needed.

Avoid Overuse of Topicals: Sometimes, heavy use of steroid creams or creams like Dermol can irritate already compromised skin if used too frequently. Try to stick to just enough to control flare-ups.

Humidifier: Using a humidifier at home can help keep your skin from drying out further.

Patience and Monitoring: Flaking often persists during Accutane therapy, but with diligent care, it can be managed. If the eczema on your arms and neck is worsening significantly, it’s important to monitor for infection (redness, oozing, pain) since dry, cracked skin can break easily.

If you like, I can suggest a step-by-step daily routine specifically for Accutane-induced dryness and eczema-prone skin that tends to give faster relief than just one moisturizer.

Raffy Karamanoukian, MD, FACS · Answer

Accutane is a go-to medication for patients with recalcitrant cystic acne. It can reduce pore size and also reduce sebum production in your skin, making it less oily; and in turn, dryer. Accutane can be used to control acne, but patients receiving the medication should be carefully monitored. In terms of skincare, always wear an appropriate sunscreen and reduce direct sun exposure. In my patients, I recommend a good ceramide moisturizer such as Elevase whenever they are on Accutane. This will keep the skin hydrated and reduce the oiliness of the skin that is associated with oil-based moisturizers.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Continuous flaky skin even after moisturising?

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