Acitretin Taper: Step‑by‑Step Guide

If you’ve been on acitretin for psoriasis or severe skin disease, you might reach a point where you want to stop or lower the dose. Jumping off the drug abruptly can bring flare‑ups or unwanted side effects. That’s why a taper—gradually reducing the dose—works better for most people.

Why Taper Acitretin?

Acitretin stays in your body for weeks after the last pill because it converts to a long‑acting metabolite. Cutting it out fast can leave built‑up drug in your system, which may cause skin irritation, dryness, or a sudden return of lesions. A slow taper gives your skin time to adjust and lets you monitor any new symptoms. It also helps doctors decide if the medication is still needed or if a lower dose can keep your skin clear.

Most patients start tapering when they’ve been stable for at least 3–6 months, have minimal side effects, and their doctor agrees the disease is under control. If you’re pregnant‑capable, tapering is especially important because acitren​t​in can stay in the body up to 2 years and cause birth defects.

Practical Taper Schedule

Every person is different, but a typical plan looks like this:

1. Check your current dose. Most presc​r​ipts start at 25 mg daily, sometimes up to 50 mg.
2. Reduce by 10 mg every 2–4 weeks. For example, if you’re on 30 mg, drop to 20 mg for two weeks, then to 10 mg.
3. Monitor skin. Keep a photo diary and note any new itching, scaling, or flare‑ups. If you see worsening, pause the reduction and talk to your doctor.
4. Watch labs. Acitretin can affect liver enzymes and lipids. Check blood work before each dose change.
5. Final step. When you reach 10 mg or lower, you can switch to every other day dosing for a couple of weeks before stopping completely.

If you experience severe dryness, joint pain, or vision changes, call your provider right away. Those can be signs the taper is too fast.

Some doctors prefer a slower drop—5 mg every 3–4 weeks—especially for people with a history of intense flare‑ups. Talk to your dermatologist about what feels right for your skin and lifestyle.

During the taper, keep up with moisturizers, gentle cleansers, and any topical treatments you were using before acitretin. This support can smooth out the transition and keep your skin barrier strong.

Finally, write down the exact dates and doses you change. Having a simple chart makes it easy to share info with your doctor and spot patterns if something goes wrong.

Bottom line: a careful, step‑wise taper lets you stop acitretin without shocking your body, reduces the risk of flare‑ups, and gives you more control over your skin health. Always coordinate with a healthcare professional, but with the right plan you can safely move toward a drug‑free routine.