Side Effects


  • alopecia
  • chapped lips
  • dry mucus
  • membranes
  • pruritus
  • peeling of eyelids, fingertips, palms and soles
  • photosensitivity


  • transient elevation of serum transaminases
  • lactic dehydrogenase


  • elevated serum triglycerides
  • elevated cholesterol
  • decreased high-density lipoprotein


  • arthralgia
  • myalgia
  • diffuse hyperostosis of the spine
  • muscle stiffness


  • eye irritation
  • blepharitis
  • photophobia
  • conjunctivitis


  • headaches
  • nausea
  • anemia
  • leukemia

Minimizing Side Effects

  • Many side effects of the skin are dose related, occurring within the first few days of therapy, and are reversible when treatment is terminated
  • They also occur particularly with high initial doses during treatment and then after at least 2 years off-therapy (after a pregnancy)
  • Liberal use of emollients and periodic use of corticosteroids can help with skin dryness
  • Hair loss is a dose-related effect and is reversible within 2 months after discontinuing therapy or a significant dose reduction
  • Hair loss and paronychia may occur with high initial doses of acitretin (greater than 50 mg/day)


  • Not to be used by women who are, or intend to become, pregnant during treatment, and for two years following discontinuation of treatment (some of the literature says 3 years…)
  • If a woman of childbearing age takes acitretin, she must use two forms of reliable birth control and have monthly pregnancy tests
  • All food, drinks or medicines containing alcohol must be avoided during treatment and for at least two months after treatment is stopped
  • Patients must not exceed the minimum recommended daily allowance of vitamin A due to additive toxic effects and increased risk of intracranial hypertension