Can you smoke on Accutane?

Accutane is a medically-prescribed treatment for severe acne, which is often seen as a ‘last resort.’ Used correctly, it can be a life changing drug – yet it comes with many side effects, alongside lifestyle restrictions such as the increased need for contraception, but is giving up smoking necessary?

What is Accutane & Why do people take it?

Accutane is a Vitamin A derivative, which you take orally as a pill. Accutane is actually the brand name, with the medication being known as isotretinoin. You may recognize the use of Vitamin A within the skincare field – topically, it is known as a retinoid, with creams, serums and treatments all being popular examples.

Accutane is a very strong drug, as it impacts the body’s hormones, which in turn reduces oil production within the skin by shrinking sebaceous glands. It also impacts how cells stick together as they die, meaning congestion and blackheads are much less likely to form. The skin’s environment becomes less favorable for other bacteria to thrive in – again, reducing acne breakouts.

Due to the nature of the drug, there are many precautions necessary when taking it. Examples of this are requiring pregnancy tests and contraception, reducing sun exposure as much as possible, and also avoiding alcohol due to the potential for liver inflammation.

Does Accutane alter your mood?

One of the most common side effects of Accutane is depression, making previous mental health issues an important factor to consider when thinking about using Accutane as an acne treatment. It acts in many ways, with the most influential leading to changes in serotonin and serotonin receptor levels within the brain. This is important as serotonin is perhaps the most important chemical in mood stabilizing, which is why Accutane is known to potentially trigger anxiety and depression. 

Some studies also link Accutane to changes within the adrenal-pituitary axis, which may impact many hormonal pathways – such as LH or FSH, both of which are reproductive hormones. 

How does smoking impact the skin?

Smoking has a wide range of negative impacts, including the increased risk of many cancers, heart disease and bone fracture. Smoking can also impact the skin, as it prematurely ages it. This occurs due to cigarette smoke containing carbon monoxide and nicotine, which will reduce blood flow, as well as the amount of oxygen and nutrients for the skin. Smoking also increases hyperpigmentation, due to the increased presence of melanin. Pigmentation is something many acne sufferers will be familiar with, so the prospect of increasing pigmentation may be enough to put you off smoking!

Can you smoke weed while on Accutane?

Unfortunately, there isn’t one clear answer to this question. Both Accutane, and Marijuana affect people in remarkably different ways – some report no side effects, whereas some people find each drug completely intolerable. This means we cannot guarantee the outcome of combining them. 

In many studies it is cited that marijuana use can lead to anxiety and panic attacks, but others show it can be beneficial for mental health as it may relax you. Both of the drugs have the potential to impact your mental health, so both should be approached with caution. Often if other drugs, such as Accutane or birth control (which is a requirement for being prescribed Accutane) are already altering your mental health, weed is likely to alter your mood further. With this knowledge, it’s a completely personal decision to be made. 

Other than the mental health aspects, weed can impact physical skin health – by increasing oil production within glands. This creates further acne, as oil and dead skin cells mix they will clog pores. There are many other ways skin health can be altered; it can dry out skin, make it easier for bacteria to thrive and also increase inflammation. Overall, it seems marijuana is not great for skin health.

Can you smoke Nicotine While on Accutane?

Nicotine is the chemical most commonly found in traditional cigarettes and vapes, and it has a wide range of negative impacts on health in general – with many of them affecting the cardiovascular system; such as increased blood pressure, increased clotting and coronary artery disease. However, these risks aren’t linked to the use of Accutane, yet there are other studies that have shown a link between smokers, who are on Accutane, and the increased risk of developing squamous cell carcinoma, which is a type of skin cancer.

Other ways smoking can impact the skin are through the vasoconstriction of blood vessels, which lead to the skin, which means less nutrients such as proteins, lipids, vitamins and minerals cannot reach the skin to nourish it. This lack of nourishment directly impacts the skin, it means the skin barrier cannot function effectively – and when this occurs it makes the skin much more susceptible to bacteria, leading to more breakouts.

So, what is the skin barrier, and why does this occur? The skin barrier is the outermost layer of the skin which can be likened to a wall – made up of cholesterol, fatty acids, and ceramides. This wall-like barrier is important as it ensures moisture is kept inside the skin, and bacteria (and other pollutants!) can be kept out. This is the key to ensuring skin health and reducing breakouts from acne. 

What Do Dermatologists Say?

The bottom line is all doctors will recommend against smoking, especially products containing nicotine, due to decades of research that points to all the negative impacts when it is used within an individual’s lifestyle. As time progresses, the opinions of smoking weed are changing – with many more doctors seeing a potential benefit to responsible use for a variety of health conditions.

However, the co-use of Accutane and marijuana together hasn’t been studied to a great enough degree for doctors to recommend its use, and with the potential mood-altering aspects of both Accutane and weed, it would be advised to avoid their usage together.

Originally Published: January 09, 2023

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Analyzed by Beth Cooper
I'm a beauty content creator from the UK, on both Instagram and TikTok. I adore exploring new beauty products, whilst also learning the science behind the skincare (I'm a major science nerd - currently studying a Bachelors Degree in Health Sciences!) I'm passionate about making acne care accessible for all, whilst empowering people to feel like they are good enough and beautiful with or without their acne. It's such a complex condition, so getting good information to people is so important to me, years of those horrendous internet DIYs really damaged my skin! Read more of Beth's articles.

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