Tattoos and Piercings on Accutane: Why You Should Wait

You might be wondering whether you can get a tattoo while on Accutane (isotretinoin). Recent evidence complicates the picture, but the overall answer is still no, or at least not yet.

This article walks through where the conventional advice comes from, how strong that evidence is, and what to do if you already booked the appointment or got the tattoo while on isotretinoin.

Can You Get a Tattoo on Accutane?

Getting a tattoo while on Accutane (isotretinoin) is not recommended. Isotretinoin changes how your skin heals: the skin becomes more fragile, and wound healing can become abnormal, delayed, with too much tissue growth and crusting, according to the effects reported on the FDA label.

US Food and Drug Administration (2002). Accutane label

Tattoos are no exception to the healing process. A tattoo is an intentional wound: thousands of needle punctures depositing ink into the upper layer of the skin, and it needs normal healing to come out well. That’s why tattoo artists and clients talk about healing so much, and why the standard advice is to follow your artist’s aftercare closely.

Tattoos also carry complication risks of their own, including infection, allergic reactions and scarring, especially in people prone to abnormal wound healing.

Serup et al. (2015). Current Problems in Dermatology

Put those together and you have a procedure that depends on healing to come out nicely, done on skin whose healing has been altered by a drug. That’s the whole argument, and it’s a reasonable one.

Where the Standard Wait Comes From

The FDA label doesn’t directly discuss tattoos. What it says is that wax epilation and skin resurfacing procedures such as dermabrasion and laser should be avoided during treatment and for at least 6 months afterwards, because of the possibility of scarring.

US Food and Drug Administration (2002). Accutane label

That guidance became the standard advice for any procedure that damages the skin, from chemical peels and laser treatments to actual surgery, so tattoos were included by default. A 2017 review confirmed the practice, noting that delaying elective procedures for 6 to 24 months after isotretinoin was common.

McDonald et al. (2017). Journal of Cutaneous Medicine and Surgery

So if you ask your provider or your tattoo artist, you’ll likely hear “at least 6 months,” and the number checks out. It’s just borrowed from guidance on other skin procedures.

What Newer Research Says

Newer research on procedures done during isotretinoin complicates the question. A systematic review concluded there was insufficient evidence to support delaying many procedures for patients on or recently off isotretinoin, including superficial chemical peels, non-ablative lasers, hair-removal lasers and vascular lasers, while still advising against fully ablative laser resurfacing during treatment. The American Society for Dermatologic Surgery’s task force reached the same conclusion the same year, adding that superficial dermabrasion is likely safe in trained hands.

Spring et al. (2017). JAMA Dermatology

Waldman et al. (2017). Dermatologic Surgery

The systematic review of wound healing was more cautious in both directions: the studies were inconsistent and methodologically weak enough that there was insufficient evidence either to support or to refute delaying elective procedures, and clinicians should weigh each patient’s situation.

McDonald et al. (2017). Journal of Cutaneous Medicine and Surgery

That’s an important point: this is a spectrum, not a black-or-white decision, and individual variables play a role. If you have a history of complicated wound healing, getting a tattoo while on isotretinoin is not wise.

Dose is a fair question too. Dose drives the degree and severity of most isotretinoin side effects, so it’s logical to wonder whether a low-dose course affects healing less than a higher-dose one. No study has tested that, so the advice doesn’t change with dose.

Ultimately, none of these reviews studied tattoos, so the conclusions don’t transfer automatically. The procedures studied were done by medical providers in controlled settings, on skin that was assessed beforehand. The conditions when you’re tattooed vary far more: artist skill, aftercare quality, cleanliness and health standards all come into play.

And while the research has become more accepting of surface-level treatments, the guidance on deeper procedures, which is where the deliberate, controlled trauma of a tattoo sits, didn’t change.

Our take: it may be tempting to get a tattoo while on Accutane (isotretinoin), but being conservative with the timing of an elective procedure you don’t have to get leaves less room for things to go wrong. Waiting 6 months so your tattoo heals perfectly is a good trade. Your provider should be your final reference on timelines. There’s more on how these findings apply to scar treatments in Does Accutane Help With Acne Scars?

Microblading, Lip Blush and Permanent Makeup

You might not think of microblading, lip blush, permanent makeup or scalp micropigmentation as tattoos, but they are. Pigment is deposited into the skin through fine cuts or punctures, and like any tattoo, the result depends on the skin healing properly. Microblading has its own record of complications even on healthy skin, from poor cosmetic results to immune reactions to the pigment.

Shishak & Kuthial (2025). Skin Appendage Disorders

On isotretinoin the same logic applies as for any tattoo, with one extra problem: brows and lips are some of the driest, flakiest skin you have during a course. Postpone it, and tell your technician about the medication when you do book. A reputable one will ask.

Getting a Tattoo Before You Start

If you haven’t started Accutane (isotretinoin) yet, the question flips: can you get tattooed now and start afterwards?

The simple answer is that the tattoo should be fully healed first. A fresh tattoo is an open wound for the first few weeks, and starting a drug that alters healing in the middle of that is the situation you’re trying to avoid. How long healing takes depends on the size and placement, and there’s no research or guideline on this, so tell your provider about the tattoo and let them set the start date.

Laser Tattoo Removal and Existing Tattoos

Removal is the one place the newer research speaks more directly. The 2017 consensus reviews found insufficient evidence to justify delaying non-ablative laser treatments in patients on or recently off isotretinoin, while still advising against fully ablative lasers during treatment. Whether your particular removal laser falls on the safe side of that line is a question for the clinician doing it, and they should know you’re taking isotretinoin.

As for tattoos you already have, nothing in the label or the research suggests isotretinoin affects healed ink. The concern is with new wounds, not old ones.

Piercings: Same Logic, Shorter Stakes

Many people also wonder whether piercings are okay while on Accutane (isotretinoin), and the answer is that isotretinoin complicates things here too. Localised infection is the most common piercing complication, and scarring and keloid formation are well documented. How a piercing heals depends on the site, the jewellery, the piercer’s hygiene and your own aftercare.

Holbrook et al. (2012). American Journal of Clinical Dermatology

Aftercare is what isotretinoin makes harder. The skin around the piercing is drier and more fragile, so cleaning solutions sting more, crusting is heavier, and the healing window is less forgiving overall.

The stakes are lower than with a tattoo, because the wound is smaller and a piercing that goes badly can be taken out. The advice is still the same: wait until the course is done.

Already Got One Mid-Course? Don’t Panic

If you already got a tattoo or piercing while taking Accutane (isotretinoin), don’t panic. There is a higher chance of poor healing, but it’s not a certainty, and many heal without incident. What you do now is what matters:

• Follow the aftercare to the letter: Clean the wound as instructed, keep it moisturised, and don’t pick at crusting, which is likely to be heavier than usual.
• Keep it out of the sun: Fresh tattoos are sun-sensitive at the best of times, and isotretinoin makes sunburn more likely. Cover it rather than relying on sunscreen on a healing wound.
• Watch for abnormal healing: Slow healing, excess crusting, or raised, lumpy tissue. Spreading redness, warmth, swelling or pus point to infection.
• Tell your provider: They can monitor it and act early if it isn’t healing as expected.

One reassurance worth knowing: the waiting periods are about skin recovery, not about the drug lingering in your system. Isotretinoin itself clears within about a week of the last dose. The advice runs to months because your skin’s healing capacity recovers on a much slower clock, and nobody has measured exactly when it resets, which is exactly why the conservative default is still the sensible one.

How to Get Prescribed Isotretinoin (Accutane) Online

If you’re wondering how or where to get isotretinoin, Happyglow connects you with US-licensed physicians who decide whether starting isotretinoin is right for you, entirely online.

1. Start your visit. Answer a few questions about your health and goals (~5 min).
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