Acne Medicine and Dry Eyes: What a Review of 43 Studies Says About Isotretinoin

Isotretinoin is an oral medicine used for severe acne. It works by shrinking the oil-producing sebaceous glands of the skin. The eyelids have their own oil glands, the meibomian glands, which add an oily layer to the tears that slows evaporation. A systematic review in Current Eye Research looked at what isotretinoin does to the eye surface.

What the review found

The authors searched MEDLINE, Embase, Scopus, and the Cochrane trials register and included 43 articles.

• Across prospective studies, worsening dry eye symptoms and objective signs of eye-surface disease were frequently reported.
• Changes were especially common in measures of meibomian gland structure and function.
• Six studies tested ways to reduce these side effects, and four reported improvements in symptoms or eye-surface measures.
• The drug may cause lasting changes to the glands in some patients, although the long-term extent and importance remain uncertain.

The authors concluded that dry eye appears to be a common and potentially serious side effect, and that patients should be informed and screened for dry eye symptoms before and during treatment.

Why this matters for contact lens wearers

A comfortable lens depends on a stable tear film. When the oil layer thins, lenses can feel dry, scratchy, or blurry by midday. If you wear contacts and are considering or taking isotretinoin, it is worth planning ahead:

• Tell your eye doctor if you are starting or taking isotretinoin.
• Report new dryness, burning, or lens discomfort rather than pushing through it.
• Ask whether shorter wearing time, a different lens, or lubricating drops approved for use with contacts makes sense.
• Do not stop a prescribed acne medicine on your own; coordinate with your dermatologist.

Our role

At Khanna Vision Institute we examine the eyelid glands and tear film and adjust lens plans when medicines affect comfort. For more plain-language eye-health reading, see moorparklasik.com.

Source: Isotretinoin and Dry Eye Disease: A Systematic Review (Current Eye Research (PubMed), 08/05/2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.