Accutane (Isotretinoin) Treatment for Acne
A class of medicine to treat acne known as retinoids is similar in structure to vitamin A. Back in 1982 Hoffman LaRoche developed this product solely for the treatment of severe types of acne. The drug is actually a derivative of Vitamin A and it virtually transformed the treatment of acne. Retinoids work by altering the transcription component of DNA. By reducing the size and output of the sebaceous glands in the body it leads to less acne. It ensures that skin cells which are often shed into the sebaceous glands and clogs them, are less gummy so they don’t form the acne in the first place. Vitamin A and hence the retinoid family of drugs can also decrease the amount of bacteria on the skin surface and actually in the sebaceous glands.
What are Accutane’s Uses?
Severe acne is the symptom for the use of Accutane. What is meant by severe acne is any acne that is nodular and filled with pus which hasn’t responded favorably to numerous rounds of antibiotics. Because Accutane has been so successful in treating acne doctors are now prescribing it much earlier in the treatment of severe acne. This is being done to prevent any significant disfigurement or scarring of the skin. And since it has been successful in treating acne so well it is not being used for some other skin diseases such as lupus, psoriasis and lichen planus (itchy rash on the skin or mouth).
How to Use Accutane
Accutane should be used with caution and of course used in accordance with the dosing instructions from the pharmacy and your doctor. There are a few different types of dosing instructions with Accutane. Usually it starts with a low dose and then the dose is increased after a couple of weeks. The general length of treatment is 4 to 5 months. At first acne can appear to get worse then it will start getting to improve with no increase in the amount of acne. The skin will appear to get drier, redder and may even be a little more painful. This is just the first side effects of the treatment; do not stop because it will get better.
Accutane Side Effects
The media has indicated that there are numerous side effects from the use of Accutane. The most contentious is birth defects in pregnant women. There can be significant birth defects such as facial, cardiac, central nervous system, thymus gland abnormalities. Because of the significant risk of birth defects women who take Accutane usually are recommended to take two different kinds of birth control. The birth control should be started one month prior to starting treatment and it should continue for one month after. It is safe for a woman to become pregnant starting a month after treatment is COMPLETED. There are several other serious side effects from Accutane use.
- Headaches with nausea, vomiting, blurry vision.
- Decrease in the amount of tear production leading to dry eyes, red eyes, itchy eyes and ulceration of the cornea. This is usually increased in those people who wear contact lenses.
- Emotional disturbances such as depression increase in suicide attempts, psychosis. All will be removed after stopping use of Accutane.
- Accutane can cause liver enzymes to become elevated which can cause jaundice, abdominal pain and hepatitis
- Night blindness and having a hard time distinguishing between black and white
- Severe dry skin and lips
- Severe itchiness of the skin
- Loss or hair or thinning of hair
- Bloody noses
- Peeling of skin on the soles and palms due to excessive skin dryness
- Significant pain and aching of muscles and joints
- Easily burning skin in the sun
- Increase in triglyceride levels
Because there are significant side effects with the use of Accutane, it is important to have regular blood work to check liver function, triglyceride levels. In fact a CBC or complete blood count should be done. All women should have pregnancy tests completed. The blood work should be conducted before treatment starts, one month after treatment and then again throughout the course of treatment.
Stopping Treatment with Accutane
Usually people take Accutane for 4 – 5 months and most people see an improvement, significant enough improvement, to stop treatment after just 4 months. Accutane continues to provide benefit for months after it has concluded. It continues to reduce scarring, lesions and redness and after it is completed acne usually responds better to more conservative treatments such as over the counter acne medicine.
Even though Accutane has been proven to be quite beneficial in the treatment of severe acne, the side effects have raised enough concern that many people turn away from it to help treat their acne. What is important to realize is that these side effects go away once treatment is stopped, nothing permanent remains. As long as a woman doesn’t get pregnant while on it no permanent harm is done. It is still one of the best treatments for severe acne and shouldn’t be overlooked.