Accutane (Isotretinoin): The Most Powerful Acne Treatment

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Isotretinoin is a drug used to treat acne. Marketed as Accutane, this medication revolutionized the world of acne treatments.

Isotretinoin is a retinoid. Its mechanism of action implies altering the DNA transcription decreasing the size and output of sebaceous glands. It reduces the stickiness of the cells casting off into sebaceous glands, preventing the occurrence of blackheads and whiteheads (comedones). It also decreases the number of bacteria on the skin.

What Is Isotretinoin Indicated for?

Isotretinoin is commonly prescribed for nodular, pustular acne, if full courses of oral antibiotics were not effective.

Besides severe acne, for which it is prescribed in the first place, it can be used to treat other disorders, including psoriasis, lupus, and lichen planus.

Laboratory Testing for Isotretinoin

Before using Accutane, patients need to undergo blood tests to check triglyceride levels, liver functions and a complete blood count. Women also need to be tested for pregnancy. These laboratory checks should be conducted periodically during the therapy.

How to Use Isotretinoin

The course of therapy lasts for 16 to 20 weeks. Usually, it is recommended to start the therapy with a low dose and increase it after a certain period.

The acne may get worse in the beginning of the therapy: acne lesions might become redder and more painful. This is a normal reaction.

One of the advantages of Accutane is that its beneficial effects do not stop after the therapy is finished. Moreover, after the therapy with Accutane, the skin responds better to conventional acne treatments.

Accutane’s Adverse Effects

The most serious side effect of Accutane is its teratogenicity, which means that it causes certain birth defects, if taken during pregnancy. Accutane can affect the foetus’s central nervous system and cause facial, cardiac and thymus gland abnormalities. Therefore, Accutane treatment should be completed at least one month before a woman can get pregnant with no risk of birth defects. Since Accutane does not affect a woman’s fertility, it is recommended to use two forms of birth control starting one month before the therapy and continuing one month after.

Other serious side effects of Accutane include the following:

  • Pseudotumor cerebri. If you have headaches that are persistent and accompanied by such symptoms as nausea, vomiting and blurred vision, this may indicate a condition known as pseudotumor cerebri.
  • Depression, psychosis, and suicidal thoughts. Accutane increases the incidence of these conditions, but the symptoms disappear after discontinuing the medication.
  • Redness and itchiness of the eyes, and ulcerations of the cornea. These symptoms are associated with Accutane’s ability to decrease the production of tears in the eyes. Ulcerations of the cornea are more likely to occur in contact lens wearers.
  • Night blindness. Accutane may decrease the ability to distinguish between various shades of black and white
  • Jaundice, hepatitis, abdominal pain. Accutane therapy can cause elevated liver enzymes leading to these conditions and symptoms.

Accutane also causes side effects that are less serious but potentially annoying: overdried skin, itchy skin, excessive peeling, dry lips, nosebleeds, thin hair, muscle pain, increased sun sensitivity, and elevated triglyceride levels.

Bottom Line

Accutane is one of the most powerful and effective acne treatments available today. When used carefully, this medication can be truly life changing for those suffering from moderate to severe acne.