Isotretinoin can cause vaginal dryness because it reduces oil production and can dry mucous membranes, not only the lips and skin. Accutane and vaginal dryness may involve irritation, thinner-feeling tissue, itching, burning, or pain during sex, and some reports suggest this may affect up to about one-third of female patients.
Care usually starts with gentle hygiene, fragrance-free vaginal moisturizers, and water-based or silicone-based lubricants during sex. Dryness is often temporary, but symptoms such as blisters, sores, unusual discharge, odor, bleeding, or severe pain should be evaluated, as they may indicate infection, irritation, or another condition.