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accutane

Isotretinoin (trade name: Accutane, Roche) is a powerful drug used in the treatment of acne. Four to five months of isotretinoin treatment usually leads to clearing of acne for one year or more after the medicine is stopped.

What is Accutane?

It is a synthetic vitamin A derivative (13-cis-retinoic acid) which is administered orally in pill form, normally for 15-20 weeks.

How does Accutane clear acne?

Exactly how Accutane works on a cellular level is unknown, but we do know that it affects all of the four ways that acne develops.

  • It dramatically reduces the size of the skin's oil glands (35%-58%) and even more dramatically reduces the amount of oil the skin produces (around 80%).
  • Acne bacteria (P. Acnes) lives in skin oil. Since oil is so dramatically reduced, so is the amount of acne bacteria in the skin.
  • It also slows down how fast the skin produces skin cells inside the pore which helps pores from becoming clogged in the first place.
  • It displays anti-inflammatory properties.

Who is a candidate for treatment with Accutane?

DermAtlas: FACE - acne vulgaris, cystic
© 2001-2011, Dermatlas

Accutane is considered for severe acne that has failed other treatments. It is a potent medication that is very effective for severe, scarring acne. Is also used for acne present for many years that has not responded to antibiotic pills and creams. Accutane or generic Isotretinoin medications is never a first choice and should never be “shared” or purchased over the internet without the guidelines of a physician.

Does Accutane guarantee a cure?

Accutane "cures" about half of those people who take it so that they never need to do anything else for acne. In the first few weeks of treatment, about one in five patients gets a little worse, and one in 500 patients gets much worse. The rest either get much better, or better for a while. There is no other known drug that comes close to being as effective for severe acne. The usual patient takes it for 4 to 6 months, but some need more and must be "retreated" for an additional 4 to 6 months.

The more Accutane one takes, the greater the chance of long term cessation of acne. Unfortunately, side effects depend on the dose as well. At the lowest doses, there are few side effects, though pregnancy risk is always a critical consideration. At higher does, over-drying can occur. Doses are adjusted to strike a balance between effectiveness and side effects.

Common side effects

  • Chapped lips (90%), countered by a using Vaseline or Aquaphor as a lip moisturizer
  • Dry skin and itching (80%) helped by frequent moisturizer creams
  • Dryness of nose, mild nosebleed (80%), helped by "AYR nasal gel"
  • Irritation of the eyelids and eyes (40%)
  • Joint and muscle pains (15%)
  • Temporary hair thinning (10%)
  • Rash (7%)
  • Intestinal symptoms (5%)
  • Urinary symptoms (5%)
  • Headache (5%)
  • Increased sensitivity to sun (5%)
  • Decreased night vision (<1%)
  • Depression, thoughts of suicide (<1%)

Patient Requirements for Accutane Use

FDA approval of Accutane requires all patients taking the drug to register with the  iPledge program. The program is designed to ensure that patients avoid pregnancy, and links prescriptions to pregnancy tests.

Accutane may increase the level of blood fats, sometimes to risky levels. This reverts back to normal when the drug is stopped. Occasionally it may affect the liver. Regular blood tests are mandated during Accutane treatment.

Cautionary Advice regarding Pregnancy

The most damaging side effect of Accutane is serious birth defects if taken during pregnancy. It is critically important for women not to take Accutane while pregnant, and not to become pregnant while taking it. View Precautionary Advice from Roche Pharmaceutical.

Women who are, or might be, sexually active while taking Accutane must use an effective method of birth control, of which the birth control pill is the most effective. Birth control pills do rarely fail, so an additional method of birth control such as a condom for the male partner or a spermicidal foam or sponge is also needed.

Should Dr. Sikorski determine you are a candidate for Accutane, the potential benefits, side effects and all requirements will be discussed.

Other Acne Therapies

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