After five years of struggling with debilitating acne, Kyle Frank felt ready to try anything.
His skin had been clear for most of his teenage years, but at 17, seemingly out of the blue, it suddenly changed.
His cheeks became dotted with angry red spots and painful bumps that wouldn’t go away – no matter what cleanser, moisturiser or serum he tried.
‘No one in my family had ever suffered with acne, so I didn’t know what to do,’ said the now-28-year-old London-based entrepreneur. ‘It got so out of hand. I began to feel desperate.’
Visiting his GP for help after over-the-counter remedies failed to clear his skin, Kyle began a years-long journey of trying prescription medication after prescription medication.
‘I had five years of different prescriptions,’ he explained. ‘And none of them worked.’
‘Some would seem to be improving my skin for a week or two, but it felt like my skin was immediately becoming resistant to them.’
Kyle Frank’s skin had been clear for most of his teenage years, but at 17, seemingly out of the blue, it suddenly changed
His cheeks became dotted with angry red spots and painful bumps that wouldn’t go away – no matter what cleanser, moisturiser or serum he tried
Visiting his GP for help after over-the-counter remedies failed to clear his skin, Kyle began a years-long journey of trying prescription medication after prescription medication
And the slew of different topical and ingestible medications, he says, left his skin almost more damaged than before.
Kyle developed dermatitis – a common condition that causes swelling and irritation of the skin – as well as redness-causing rosacea.
‘I had veins that appeared across my nose and cheeks – I looked like an old man,’ he said.
‘I went into a shopping centre to speak with skin specialists and they told me that it was because the capillaries, or blood vessels, in my skin were damaged – something that typically happens in old age.’
Eventually, as a last resort, Kyle’s dermatologist agreed to prescribe the then-19-year-old isotretinoin – an acne treatment only available for severe cases of acne that failed to respond to normal treatment.
Within two weeks, however, Kyle bitterly regretted his decision.
‘I woke up and could barely move or walk,’ he said. ‘I felt like a tin man – it was so painful. I’m usually quite an active person, but I couldn’t do anything. It was like I had been in a road-traffic accident.
‘I had a signed a paper listing side-effects, but I was never told that joint pain could be an issue. I wish someone had warned me.’
Acne medication isotretinoin, sold under the name Roaccutane, is prescribed to nearly 50,000 people in the UK every year.
Since its approval, isotretinoin has also triggered more than 8,000 reports to the MHRA of adverse effects, ranging from vision problems and anaemia to joint and muscle pain and even seizures
First licensed in 1983, guidance currently allows isotretinoin to be prescribed for cases of severe acne that is resistant to other treatments, or acne that might cause permanent scarring.
The drug works by preventing the skin from producing oils that acne-causing bacteria feed on.
For some, it can be transformative – getting rid of even the most persistent acne. Studies have shown that patients’ skin tends to clear up within just four months and the majority are ‘cured’.
But the medication’s serious side-effects mean it can only be prescribed by dermatologists – and can leave some with excessively dry skin, rashes, headaches and back pain.
In rare cases it can damage the liver, and women are advised not to conceive while on the drug due to possible birth defects.
Since its approval, isotretinoin has also triggered more than 8,000 reports to the Medicines and Healthcare products Regulatory Agency of adverse effects, ranging from vision problems and anaemia to joint and muscle pain and even seizures.
The drug can also cause mood problems, and has been linked to several suicides in recent years.
In Kyle’s case, the drug left him with excessively sore joints and muscles – a known, though rare, side-effect of isotretinoin, which is thought to affect the cells lining the joints.
Just a few weeks of taking the drugs, Kyle began to find it difficult to get out of bed in the mornings. After a little more than a month, he says he could barely move.
‘My joints hurt and were so stiff, I couldn’t even get up, let alone go out of the house,’ he said. ‘It was so incredibly isolating. I was the only person in my family who had ever dealt with something like this, so people didn’t really understand the extent of it.
‘I felt like the life was being sucked out of me.’
At that point still on a relatively low dose of the drug, Kyle decided to stop taking it after just seven weeks. Within a few days, his stiffness improved and he began to feel better.
But Kyle says he still feels the lasting impact today, occasionally struggling with joint issues.
‘My doctor never mentioned that this was a potential side effect of the medication,’ he says. ‘If I knew, I would never have taken it, given that I still have inflammation and pain in my knees and hips today.’
After stopping isotretinoin and swapping to more natural alternatives, Kyle’s skin has massively improved, he says
‘I was only on it for a relatively short time and I’ve been left with lasting pain. Imagine the damage it could have done if I’d stayed on it,’ he said
Kyle now runs his own skincare brand Frank’s Remedies, using the same ingredients he used to soothe his skin
‘I was only on it for a relatively short time and I’ve been left with lasting pain. Imagine the damage it could have done if I’d stayed on it,’ he said.
While some campaigners have sought to ban the drug due to its potentially severe side-effects, a three-year review of the drug by a government medical watchdog concluded that its benefits outweighed the risks in 2023.
Several studies, likewise, whereby doctors have compared mental-health problems in acne patients taking Roaccutane, versus those taking other strong treatments such as antibiotics, have found similar levels of mental illness across both groups.
Kyle acknowledges that he may be an outlier in the severity of his side-effects.
But he hopes that other young people will also realise that isotretinoin is not their only option.
‘When I was thinking about starting isotretinoin, I remember looking on TikTok and seeing so many videos of young people saying it could give them a slimmer nose because of its drying effect on the body,’ said Kyle.
‘There were people asking how to be prescribed it without having acne, because they wanted to change their face, rather than clear up their skin.’
‘At that point, I had been through so many abrasive treatments that my skin barrier was basically completely destroyed,’ he explained.
‘So after quitting isotretinoin and starting university, I started exploring ways of repairing my damaged skin through more natural remedies.
‘Unsurprisingly, as soon as I focused on doing this, and stopped stressing about my acne, my skin began to improve.’
Roaccutane’s manufacturer, pharmaceutical company Roche said: ‘We take the safety of all our medicines very seriously. Millions of patients worldwide have taken Roaccutane, but like most medications, it can have side-effects. It is vital that patients are fully informed as to what to expect when they take it and that they are monitored closely to ensure they get the ongoing care they need.’
