How to Safely Discontinue Acitretin

If you’ve been on acitretin for severe acne or psoriasis, you might reach a point where you need to stop. Maybe your skin cleared up, you’re planning a pregnancy, or you’re hitting unexpected side effects. Quitting isn’t as simple as tossing the bottle away – you need a plan to avoid flare‑ups and protect your liver and skin.

Why You Might Need to Stop

Acitretin stays in your body for a long time. Doctors usually recommend stopping it if you become pregnant, develop serious liver problems, or if the medication isn’t delivering the results you expected. Some people also stop because they experience dry skin, joint pain, or high cholesterol that won’t go down.

Talk to Your Doctor First

Never make the call on your own. Your dermatologist will check your liver enzymes, lipid panel, and pregnancy status before giving the green light. They may order blood work to see how your body is handling the drug and decide if a gradual taper is needed.

When the doctor approves discontinuation, they’ll often suggest a step‑down schedule. Cutting the dose in half every two weeks gives your skin a chance to adjust and reduces the risk of a sudden acne breakout.

During the taper, keep a symptom diary. Note any new dryness, itching, or joint soreness. If anything spikes, call your doctor right away – they might pause the taper or add a short‑term moisturizer or anti‑inflammatory pill.

Don’t forget about contraception. Acitretin and its metabolites can linger for up to three years after the last dose. If you’re a woman of child‑bearing age, use two forms of birth control (e.g., condom plus hormonal method) for the full three‑year window. Men should also avoid fathering a child during this time unless they’re absolutely sure the drug is cleared.

While you’re off acitretin, support your skin with gentle cleansers, fragrance‑free moisturizers, and sunscreen. Your skin may be more sensitive after stopping, so a good barrier helps prevent irritation.

If your acne or psoriasis starts to flare, discuss alternative treatments with your doctor. Options include topical retinoids, vitamin A derivatives, or newer biologics that target specific immune pathways. Switching early can keep your skin from worsening while you recover from acitretin.

Finally, schedule a follow‑up blood test about a month after you finish the taper. This confirms that liver enzymes and cholesterol have returned to normal. If they’re still elevated, your doctor might recommend lifestyle changes or a short‑term medication to bring them back in range.

Stopping acitretin doesn’t have to be scary. With a clear plan, regular labs, and good skin care, you can transition smoothly and keep your skin looking its best.