Suicide, nosebleeds and an intimate male affliction... just some of the side effects men suffer from 'gold standard' medication taken by 1 million Americans

Millions of people use it worldwide but an increasing number are now coming forward to talk about the disturbing side effects of Accutane.

Commonly prescribed for acne, the medication works by significantly reducing oil (sebum) production in the skin, preventing clogged pores, and decreasing inflammation and bacteria associated with breakouts.

Dry skin, lips and eyes, as well as nosebleeds are listed as some of the common side effects.

Matthew, a teenager from Australia - who does not give his last name - says being on the medication, known generically as isotretinoin, left him with an array of problems that are less commonly talked about.

He was put on a cream form of the medication at the age of 15 in 2023 to treat acne, but within several months he noticed a difference in his mood. Then other health issues started creeping in.

Some of his complaints, which were originally dismissed by his doctor, included sexual dysfunction, constant fatigue, irritable bowel syndrome and severe depression.

Matthew said he was warned about some of the side effects beforehand including suicidal ideation, dry skin and dry eyes, but he wasn't aware that testosterone disruption, erectile dysfunction or irritable bowel syndrome could be other possible outcomes.

When he told his doctor about his mood changes, the physician simply recommended anti-depressants and suggested the other symptoms could be related to depression.

In a YouTube interview with former FDA Medical Officer Dr Josef Witt-Doerring, Matthew explained: 'I experienced fatigue, sexual dysfunction, and a psychological change.

'And then, I slowly began to struggle in the gym around mid-2023 when I was 16. I just became even more fatigued and couldn't put on any muscle or any gains in sprinting or the gym despite working out consistently, eating perfectly, sleeping on time.'

He continued: 'That was when I started to have suspicions that my testosterone was affected. And that that was honestly what led me to start researching Accutane and finding out more about it.'

Matthew found 'hundreds of posts' online from men talking about how Accutane had impacted their testosterone levels and made them depressed.

Matthew then had his testosterone levels tested and he got a result of 390 ng/dL, which is generally considered low for adult men.

While the 'normal' range is often cited as 300-1200 ng/dL, many experts consider levels below 400 ng/dL to be in the low range, especially for younger men.

Concerned about his health, Matthew decided to quit Accutane and he quickly found his symptoms dissipated.

He had his hormone levels retested a year later and his testosterone was at 600 ng/dL.

Matthew said: 'I was working at McDonald's [at the time], you know, a greasy place, late at night. I was eating a lot of processed food with a lot of protein in it... like protein bars, protein powder.

'And when I went to see my doctor about my acne, he never asked me about any of those things. How was my lifestyle? What was I eating? He put me straight on that cream.'

In the UK, two specialists now have to sign a prescription before isotretinoin can be given to anyone under 18.

The change, which came into play in 2024, was introduced after it emerged the drug's debilitating side effects may have led to the suicides of several young people.

Some advocates are even pushing for the drug to be banned, including one father of a young patient who died by suicide in the UK.

Jonathan Medland, 67, from Barnstaple, lost his son Jon to suicide in 2004 shortly after he stopped taking isotretinoin.

Medland claims the drug contributed to the 22-year-old medical student's death and said his son had never shown signs of depression before the treatment.

He also accuses doctors of doling the drug out 'like Smarties because it's an easy fix'.

Isotretinoin was first licensed in the 80s and is still regarded as the gold-standard treatment for severe acne that has failed to respond to other medicines.

Currently taken by more than 1 million patients in the US, it works by preventing the skin from producing oils that acne-causing bacteria feed on.

Studies suggest patients' skin clears up after just four months and the majority are virtually 'cured'.

However, the drug can be prescribed only by dermatologists due to its potential side effects. The most common include dry skin, rashes, headaches and back pain.

Matthew said he saw his dermatologist only twice while he was taking Accutane for 12 months and she encouraged him to continue the treatment plan, despite him voicing his concerns.

In the US, patients must also be monitored with regular blood tests, because in rare cases the medication can damage the liver, and women are advised not to conceive while on the drug due to possible birth defects.

Between 1982 and 2000 the FDA received reports of 394 cases of depression, and 37 suicides occurring in patients exposed to isotretinoin.

It is the fifth most common drug reported to the US Adverse Event Reporting System (AERS) in association with depression, and the 10th most common (and the only non-psychotropic drug) in suicide reports.