Accutane sexual side effects: can they last?

Accutane (isotretinoin) can lower your sex drive and cause erection problems, vaginal dryness or less feeling in the genitals. UK and US labels now warn these problems may continue after stopping, which is part of post-Accutane syndrome, or PAS.

The NHS page on isotretinoin lists problems with sex but doesn’t say they can last. Ask about sexual side effects before you start, and report them if sex still feels different after your course.

Matthew was 15 when a dermatologist prescribed Accutane for his acne. He says he was told he’d be exactly the same afterwards as he was before.

Play video: He Took Accutane at 15. Now He’s Living with the Damage

About three months in, the sexual side effects began. He stopped after about a year and waited for them to go, because he’d been told they were temporary. “All that persisted,” he says, including the erection problems.

What are the sexual side effects of Accutane?

The UK leaflet names five: trouble getting or keeping an erection, lower libido, vaginal dryness, difficulty having an orgasm and reduced sensation in the genitals.

In everyday words, that can mean wanting sex less, or touch that feels numb. One patient told a UK expert review of the medicine: “Mechanically, I can have an orgasm, but there is no mental pleasure and everything feels kind of numb and disconnected.”

Nobody knows how often they happen. The leaflet says the frequency “cannot be estimated from the available data”.

Can Accutane’s sexual side effects last after stopping?

Yes, for some people. The UK leaflet says there have been reports of “long-lasting sexual problems where the symptoms have continued despite stopping treatment”.

That line was added in 2023, on the advice of the UK expert review. Its experts read the side effect reports people had sent to the medicines regulator, the MHRA. Where men with erection problems said what happened after stopping, about half said the problems carried on.

Play video: Newcastle dermatology - Isotretinoin

In June 2026 the FDA, the US regulator, told every isotretinoin maker to list sexual problems “that may continue after discontinuation of treatment”. Until then, the labels on US generic versions of Accutane didn’t mention sexual side effects at all.

The FDA said it hadn’t found “reasonable evidence” that isotretinoin causes these problems, so it didn’t add a formal warning. It added the line because of what people reported. Some had needed specialist help, it noted, “often with little to no improvement”.

For some people it has lasted years after stopping. Nobody knows yet who will be affected, or whether it will ease.

Can Accutane affect you sexually later in life?

Some people only notice a change later. Many start isotretinoin as teenagers, and the UK review noted that those not yet sexually active may take time to realise something has changed. In girls and women, it added, some changes may be “less immediately obvious”.

Stefan took a short course of Accutane at 15. He told the YouTube channel Moral Medicine he hadn’t yet had “an actual sexual relationship with another person”. Nearly 19 years on, he says his libido “is just non-existent”.

The people in the FDA’s reports were young too. Among those whose problems continued after stopping, half were 21 or younger.

UK prescribers are now told to ask about any sexual problems before you start, and to watch for new ones during the course. That gives you a “before” to compare with. The UK guidance for prescribers also says young people can be offered the chance to discuss the risks without their parents in the room.

What can I do?

These medicines help many people. If you have side effects, that’s a decision for you and your prescriber. The UK leaflet says to talk to your doctor about any sexual problems during treatment.

If the problems haven’t lifted since you stopped, tell your GP and give your dates: “Isotretinoin 20 mg from March 2024, last capsule September 2024.”

Matthew’s GP, he says, put his sexual problems down to the way he thought about sex. Many people say it took time to be taken seriously. Bring the leaflet line. You can report it without a doctor agreeing.

Report it: it helps everyone

A doctor’s note helps you. A report to the medicines regulator helps everyone else: it is how patterns get noticed.

• No proof needed. A suspicion is enough, even years after stopping.
• Where: the Yellow Card scheme in the UK, MedWatch in the US.
• Use the right words. PAS has no term of its own in the regulators’ dictionary yet, so say that the symptoms continued after you stopped.

Our reporting guide walks you through it

What else do people ask?

Could it be my acne or my mood? Both can play a part. The FDA notes that severe acne, depression and anxiety can all affect sex. Criteria that doctors drew up in 2022 for the sexual form of PAS ask what sex was like before isotretinoin, and look for other causes first. Having a mental health diagnosis doesn’t rule it out.

Does it get better? Some people improve and some don’t. How many get all of their sexual function back “has never been properly investigated”, say the doctors who wrote the 2022 criteria. Stefan says the numbness has eased a little, though he can still go weeks without being in the mood.

Is PAS only about sex? No. Post-Accutane syndrome can also affect mental health, cognition (such as memory) and the body. Joseph took isotretinoin at 13. He says severe anxiety began months after his course had ended.

Matthew was told he’d be the same afterwards as before. If sex hasn’t felt the same since your last capsule, a report is how the regulator finds out.

Sources

1. Roaccutane 10 mg soft capsules, patient leaflet, Electronic Medicines Compendium (EMC 100633), revised April 2026. Section 2, sexual problems and “long-lasting sexual problems” after stopping, and “Talk to your doctor if you experience any sexual problems during treatment”; section 4, sexual side effects listed under “Unknown frequency”.
2. Roaccutane 10 mg soft capsules, summary of product characteristics, EMC 100633, revised 27 April 2026. Section 4.4, sexual disorders: counselling before the prescribing decision, with “the option to discuss without parents or carers present where appropriate”; asking about sexual function before treatment and monitoring during it. Section 4.8, sexual dysfunction listed as frequency not known.
3. NHS, Isotretinoin (Roaccutane), page last reviewed 26 June 2026. Lists “problems with sex”; does not mention that they can continue after stopping.
4. Commission on Human Medicines, Report of the Isotretinoin Expert Working Group, April 2023. Section 5.3 covers 184 Yellow Card reports of sexual side effects up to 20 May 2021, from people aged 14 to 50. On erectile dysfunction: “where information was provided, half of men reported their erectile dysfunction did not stop when they stopped their isotretinoin”, some for up to 24 years. Adolescents “may not be fully sexually active” and may take time to notice. Female sexual dysfunction “may be less immediately obvious”. The patient quote is from the call for information, section 5.3.4.3.3. These are voluntary reports, often missing dates and doses, and the review could not say isotretinoin definitively caused these effects.
5. MHRA, Drug Safety Update, 26 April 2023: new warnings for sexual dysfunction, “including the possibility of persistence after treatment discontinuation”. MHRA, Drug Safety Update, 31 October 2023: product information updated; reports welcome “at any time”, “particularly if a side effect continued or started after treatment was stopped”.
6. US Food and Drug Administration, response to citizen petition FDA-2018-P-4088, 16 June 2026, to a petition from David Healy received on 29 October 2018. Granted in part and denied in part. The FDA found no “reasonable evidence of a causal association”, so it added no formal warning. It notified makers to add “sexual dysfunction that may continue after discontinuation of treatment” to the Adverse Reactions section. The approved labelling for generic products relying on Accutane “does not include any information on sexual dysfunction”. The median age was 21 in the cases it evaluated where problems continued. Specialist referrals came “often with little to no improvement”. Severe acne, depression and anxiety are noted as other causes of sexual problems.
7. Absorica and Absorica LD (isotretinoin), US prescribing information, DailyMed, US National Library of Medicine, revised August 2026. Section 6, reproductive system, now carries the line.
8. Healy D, Bahrick A, Bak M and colleagues. Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin. Int J Risk Saf Med 2022;33(1):65-76. Section 6, post-retinoid sexual dysfunction (PRSD). Incidence “unknown”; full recovery “has never been properly investigated”; a current mental health diagnosis “does not prevent a diagnosis”. An expert consensus built on reports to RxISK.org, a website linked to three of the authors.
9. Josef Witt-Doerring (Dr. Josef), He Took Accutane at 15. Now He’s Living with the Damage, interview with Matthew, 18 July 2025. Sexual side effects from about 3 minutes; “all that persisted” at about 20 minutes; his GP at about 12 minutes.
10. Newcastle Hospitals, Newcastle dermatology - Isotretinoin, 29 November 2024.
11. Moral Medicine, interview with Stefan about Post Accutane Syndrome (YouTube), 11 December 2024. Libido and numbness from about 22 minutes; “an actual sexual relationship” at about 56 minutes. We don’t link the film, because its first minute recalls another young man’s suicide. If you’re struggling, the Samaritans are on 116 123 in the UK. Our page: Stefan’s story: Accutane at 15.