25 Significant side effects reported with the use of oral isotretinoin including: epistaxis, cheilitis, xerosis, skeletal hyperostosis (after 6 to 12 months of use), conjunctivitis, facial dermatitis, rhinitis sicca with nosebleed, skin fragility, itching, headache, appetite changes, fingertip peeling, inflammation of the urethral meatus, hair thinning, dryness of mouth (with feeling of thirst), allergic reaction, and elevated AST, ALT, ALP, and ESR24, , -27. The gene discussed is GPT; the disease is epistaxis.