Acitretin Side Effects: What You Need to Know Before Taking It

When you’re prescribed acitretin, a powerful oral retinoid used mainly for severe psoriasis and other skin disorders. Also known as Soriatane, it works by slowing down skin cell growth—but that same power brings real risks. This isn’t a mild acne pill. It’s a strong medication meant for stubborn cases, and if you’re considering it, you need to know what you’re signing up for.

Most people taking acitretin, a synthetic retinoid derived from vitamin A report dry skin, cracked lips, and peeling hands. These aren’t just annoyances—they’re signs the drug is working, but they can get bad enough to stop treatment. Some users get nosebleeds, muscle aches, or hair thinning. More serious issues include liver damage, high triglycerides, and vision changes. And if you’re a woman of childbearing age? You absolutely cannot get pregnant while on this drug—or for at least three years after stopping. That’s not a suggestion. It’s a medical requirement backed by real cases of birth defects.

Acitretin doesn’t work the same way as isotretinoin, another retinoid often used for acne. While both come from vitamin A, acitretin stays in your body longer and is mostly used for psoriasis, not acne. That means the side effect profile is different. You won’t see the same acne-related dryness, but you might face more liver strain or joint pain. People who’ve tried both say acitretin feels harsher on the body, especially if you’re older or already have liver or lipid issues.

What you won’t find in most brochures is how much lifestyle matters. Drinking alcohol while on acitretin can turn a manageable side effect into a dangerous one—it turns the drug into a form that lingers in your body for years. That’s why doctors tell you to skip the beer, wine, or cocktails entirely. Sun exposure? You’ll burn faster. Moisturizer? You’ll need it every single day. And if you’re on other meds—like cholesterol drugs or methotrexate—you need to talk to your doctor. These combinations can raise your risk of muscle or liver damage.

Some people take acitretin for months and feel fine. Others stop after a few weeks because the side effects were too much. There’s no one-size-fits-all answer. What matters is tracking your body’s signals. If your lips crack open, your vision blurs, or your muscles ache for no reason, don’t wait. Call your doctor. The goal isn’t just to clear your skin—it’s to do it without wrecking your health.

Below, you’ll find real patient experiences and medical insights on how acitretin affects people differently. Some share how they managed dryness. Others warn about blood tests they wish they’d done sooner. You’ll also see how it stacks up against other treatments, what to do if you miss a dose, and why timing matters more than you think. This isn’t just a list of side effects—it’s a practical guide to surviving the treatment.