A dermatologist’s take on whether you can drink on Accutane

Table of Content:
Why can’t you drink on Accutane? | Real risks versus occasional indulgence | What the science says | Individual factors | Discuss with your dermatologist | Tips if you choose to drink | How long after isotretinoin can I drink? | Signs to contact a doctor after drinking | Full honesty after drinking | Enjoy life without drinking

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If you’re considering Accutane—also known by its generic name, isotretinoin—you’ve probably already done some research and understand that it’s not your average acne medication. This powerful treatment is typically prescribed for moderate to severe acne that hasn’t responded well to other therapies. And while Accutane is highly effective, it also comes with a long list of responsibilities, precautions, and lifestyle changes that you’ll need to commit to for several months.

Most people begin their Accutane journey with questions about the costs associated with Accutane, insurance coverage, and potential side effects. But right after that, the next concern often centers around what you’ll need to change in your daily routine while on medication. From strict birth control requirements to increased skin sensitivity and regular lab work, Accutane treatment can require a complete lifestyle shift—and a big lifestyle consideration is alcohol use.

Dr. Eric Howell, board-certified dermatologist, says that one of the questions that he often gets from patients is whether an occasional glass of wine or weekend cocktail does any harm? Or if patients need to give up alcohol altogether until their treatment is complete? The short answer is: it depends. Everyone reacts differently, and there’s no universal rule that fits all patients. 

Why can’t you drink alcohol when taking Accutane?

1. Accutane and alcohol can strain your liver and cause potential damage

Dr. Howell says that Accutane is processed by your liver, and one of its possible side effects is liver stress or damage. About 15% of people on Accutane show higher liver enzyme levels, which means the liver is working harder than normal. These changes are usually not permanent, but they’re a sign your liver is under pressure¹. 

Alcohol is also processed by the liver and can cause problems like inflammation or even liver disease if overused. When you take Accutane and drink alcohol, your liver has to handle two substances that can both be hard on it. This raises the risk of liver damage and can make it harder for your doctor to tell what’s causing any issues in your blood tests.

That’s why regular lab checks are so important during treatment—and why drinking can complicate your care or even lead to stopping Accutane early.

2. Drinking on Accutane can elevate triglycerides and cause risk of pancreatitis

Accutane can raise your triglyceride and cholesterol levels—about 1 in 4 people taking it may experience this. For most, it’s a mild increase, but it can be more serious, especially if you have a family history of high cholesterol or poor eating habits².

Alcohol also raises triglycerides by pushing your liver to make more fat particles. So, if you drink while on Accutane, your triglyceride levels could climb even higher.

Dr. Howell says that if those levels get too high, it can lead to pancreatitis—an inflammation of the pancreas that causes severe pain and can be dangerous. It’s one of the most serious risks of mixing Accutane and alcohol, but it’s also something you can avoid with the right precautions.

3. Alcohol and Accutane can impact your mental health 

There is ongoing debate about isotretinoin’s association with mood disorders, some studies suggest no significant link between isotretinoin use and depression or suicide^{3 4 5}. However, some research indicates a potential association, especially in individuals with a history of mental health issues.

Alcohol is a central nervous system depressant. It can lower inhibitions and temporarily elevate mood, but its longer-term effect can include worsening depression, disrupting sleep, increasing anxiety, and impairing emotional regulation⁶. Combining a medication with a possible psychiatric side effect profile with alcohol, which also affects mood and cognition, can heighten emotional instability and increase the risk of adverse mental health outcomes.

This is especially important for teens and young adults—the population most likely to be prescribed Accutane—who are already at a higher risk for mood disorders.

4. Alcohol and Accutane combined can increase your side effects

Common side effects of Accutane include dry skin, cracked lips, nosebleeds, joint pain, and fatigue. Alcohol can worsen these symptoms. For example, alcohol dehydrates the body, which can intensify dryness of the skin and mucous membranes⁷. Nausea and fatigue—also associated with both alcohol and Accutane—may be amplified when the two are combined.

Besides, early in treatment, some people experience what’s known as the “Accutane purge”—a temporary worsening of acne as your skin adjusts. Alcohol is inflammatory and dehydrating, which may make this purge phase more intense. Avoiding alcohol can support a smoother transition and help your skin settle down faster.

How much can you drink on Accutane? Real risks versus occasional indulgence

Dr. Howell says that one of the most common questions patients ask during Accutane treatment is whether the occasional drink is truly harmful—or if total abstinence is the only safe route. 

While most dermatologists lean toward recommending complete avoidance of alcohol, especially at higher doses or early in the treatment course, there are a few cases where one drink may be acceptable—if specific conditions are met.

Can you drink moderately while on Accutane?

Dr. Howell says that “drinking in moderation” can look different for everyone, depending on your health history and lab results. For someone with no liver issues and consistently normal blood work, having a single drink once in a while might not cause harm—if your dermatologist gives you the green light. But that’s a big “if,” and even then, caution is key.

The reality is that Accutane is most often prescribed to teenagers and young adults, usually between the ages of 15 and 25. And let’s be honest—once drinking starts, it can be really hard to stop at just one. Whether it’s peer pressure, social events, or just losing track, sticking to strict limits can be tough in real-life situations.

That’s why, for most young people in this age group, it’s safer and simpler to avoid alcohol altogether during treatment. Choosing to abstain removes the temptation, protects your liver, and supports the best outcome for your skin and overall health.

Lack of scientific evidence between moderate alcohol use and isotretinoin

Dr. Howell says there isn’t much research on whether it’s safe to drink small amounts of alcohol while taking Accutane. Most advice comes from what doctors know about how the drug and alcohol affect the body. Since both can stress the liver and raise fat levels in the blood, there’s enough reason to be careful and avoid mixing the two.

Importance of individual factors like age, dosage, liver health, and blood work

Dr. Howell says whether drinking one drink per week is a reasonable choice depends on individual factors:

• Age: For most young people it can be very hard to stop drinking after they have had one drink, that is why he recommends avoiding alcohol altogether.
• Dosage: Higher doses of Accutane increase the burden on the liver and the likelihood of side effects, so even minimal alcohol could pose more risk.
• Liver health: If you have any pre-existing liver conditions or if your liver enzymes become elevated during treatment, alcohol should be avoided completely.
• Blood work: Regular monitoring of your liver function and lipid profile helps guide decisions. If your tests are abnormal at any point, that’s a strong reason to avoid alcohol entirely.

What you should discuss with your provider before deciding if you will have a an occasional drink while on Accutane

If you’re considering having one occasional drink while on isotretinoin, bring it up with your dermatologist early in the treatment. Important topics to cover include:

• Your dosage and how long you’ve been on Accutane
• Your most recent liver function and lipid panel results
• Any pre-existing liver or metabolic conditions
• Your drinking habits

This conversation helps tailor your care to your unique health profile, rather than applying a one-size-fits-all rule.

Monitoring and adjusting based on lab results and personal tolerance

Your dermatologist will likely schedule regular blood tests—usually every 4 to 6 weeks—to monitor your liver enzymes and lipid levels. If those values remain within a safe range and you are otherwise healthy, your provider might allow an occasional drink on a special occasion.

On the other hand, if your lab results show even mild abnormalities, or if you experience side effects that could be worsened by alcohol, it’s likely he will advise you to abstain from alcohol completely. 

Tips if you choose to drink

If you and your dermatologist decide that occasional, moderate alcohol use is acceptable during your Accutane treatment, there are still important precautions to take. These tips can help reduce potential risks and ensure you’re not compromising your health—or the effectiveness of your acne treatment.

• Limit the amount: Stick to one standard drink (e.g., a 5 oz glass of wine, a 12 oz beer, or 1.5 oz of spirits).
• Don’t drink on consecutive days: Give your body time to recover—don’t consume alcohol two days in a row, and avoid it around the time your lab works.
• Stay hydrated: Drink plenty of water before, during, and after alcohol consumption to help offset the dehydrating effects of both Accutane and alcohol.
• Eat beforehand: Having food in your stomach can slow the absorption of alcohol and reduce the strain on your liver.
• Avoid certain foods: fried and fatty foods, sugary foods and drinks, refined carbohydrates, processed meats. 

How long after taking isotretinoin can I drink alcohol?

Dr. Howell says that after finishing isotretinoin, it’s recommended to wait about one month before drinking alcohol. This allows the medication and its metabolites to fully clear from your system and reduces the risk of liver stress. If you experienced any liver-related side effects during treatment, it may be wise to consult your doctor before drinking.

Signs you should contact a healthcare provider after drinking while on Accutane

Even with precautions, alcohol can trigger side effects or changes that require medical attention. Contact your provider right away if you experience:

• Unusual fatigue or weakness
• Persistent nausea or vomiting
• Yellowing of the skin or eyes (jaundice)
• Abdominal pain, especially in the upper right side
• Dark urine or light-colored stools
• Worsening mood changes, such as increased anxiety or depressive symptoms

*These may be signs of liver stress or other complications that need immediate evaluation.

Why full honesty with your parents and healthcare providers is important

It might feel tempting to lie about your alcohol intake when talking to your parents or your healthcare provider—but telling the truth is key to your safety. 

Your healthcare providers are there to help guide you through treatment as safely as possible. Knowing if and how much you drink helps them interpret your lab results accurately and tailor your care accordingly. Being honest allows for a collaborative, trust-based approach that protects both your skin and your overall health.

Enjoying life without drinking

Committing to Accutane is a big step, and giving up alcohol—even temporarily—can feel like a challenge, especially at a young age and in social settings. But taking a break doesn’t mean sacrificing fun or connection. In fact, it can open the door to new experiences and healthier habits. 

Here are some ideas to help you enjoy life alcohol-free during treatment:

1. Host a mocktail night

Invite friends over and make creative non-alcoholic drinks together. There are tons of fun recipes using fresh fruit, herbs, and fizzy mixers. You’ll still get the social vibe of a party—without the hangover or liver stress.

2. Try out new activities that don’t revolve around alcohol

Not every great night out has to involve alcohol. Plan beach bonfires, movie nights, hikes, bowling, escape rooms, laser tag, mini golf, skating, or going to a comedy show are all great group activities that don’t center around drinking. These are the memories that really stick.

3. Get into fitness or movement you enjoy

Now’s a perfect time to try a new type of workout or sport. Dance classes, yoga, pilates, hiking, or joining a recreational sports team are all ways to feel great, release stress, and stay active without any alcohol involved.

4. Be the designated driver (and own it)

Offering to be the designated driver for your group puts you in control of the night—and everyone loves a responsible friend. You still get to be part of the fun while avoiding pressure to drink.

5. Start a new hobby or passion project

Whether it’s photography, learning guitar, painting, writing, or even thrifting and reselling clothes online—channeling energy into something creative and personal is incredibly rewarding and can be a huge confidence boost.

6. Focus on skin-friendly self-care

Use this time to lean into skincare and wellness. Try relaxing evening routines, facial masks, journaling, or anything that helps you unwind and recharge.

7. Watch the glow-up happen

Use this time to focus on how your skin, mood, and confidence are improving. Remind yourself that you’re investing in long-term health and clearer skin—and that temporary sacrifices are worth the payoff.

Article References:
https://www.ncbi.nlm.nih.gov/books/NBK547857/
https://jamanetwork.com/journals/jamadermatology/fullarticle/1910307
https://pubmed.ncbi.nlm.nih.gov/32088269/
https://pubmed.ncbi.nlm.nih.gov/32639529/
https://pubmed.ncbi.nlm.nih.gov/38019562/
https://medlineplus.gov/alcohol.html
https://www.medicalnewstoday.com/articles/alcoholic-skin#short-term-effects

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