The chemical name of accutane is actually isotretinoin. It belongs to a family of drugs known as retinoids. Isotretinoin works by reducing the sebaceous gland activity and is also anti-inflammatory. It also prevents the formation of new comedones and indirectly reduces the number of P. acnes bacteria in the sebaceous gland and on the skin surface.
Isotretinoin is recommended for treatment of nodular acne and severe acne that does not respond to all other medications. It is usually a last resort prescription, but in recent years it has become a trend that accutane is prescribed earlier in the course of acne treatment to prevent any possibilities of significant scarring.
Treatment with isotretinoin is available in the form of 10 or 20 mg capsules. A full course of treatment usually takes four to eight months. Most doctors prescribe the drug to patients based on body weight, starting with a low dosage and increasing gradually over several weeks. After one to two weeks, the patient will observe their skin getting less oily, and after about a month, the acne will show some signs of clearing. In some people however, they might feel that their acne seem to get worse in the beginning weeks of therapy, but this is temporary and will eventually improve
Prior to starting isotretinoin treatment, doctors will usually perform a blood test on the patient to check on their liver functions and triglyceride levels. Women should also have a pregnancy test to make sure they are not pregnant as isotretinoin has been reported to cause harm to unborn babies. Women who wishes to take isotretinoin but are sexually active should be responsible enough to plan a reliable form of contraception as pregnancy should be avoided throughout the therapy.
Besides the important precautions taken towards pregnancy, isotretinoin also carry certain side effects. You should always be aware of these potential side effects before deciding whether to even start the treatment.
Common side effects:
1) Dry, cracked and sore lips - These could be relieved by applying Vaseline or moisturizers.
2) Dry, irritated eyes - Patients who wear contact lenses may experience more discomfort as the production of tears is decreased.
3) Dry skin - This affects especially patients already suffering from eczema. Frequent use of moisturizers may be required.
4) Dry mouth and nose - Sometimes nosebleeds may occur.
Other severe side effects to note:
1) Headaches, nausea, vomiting - This could be due to a rise fluid pressure within the brain (intracranial pressure). Patients on isotretinoin must be cautious not to take vitamin preparations containing high dosages of vitamin A or oral tetracycline antibiotics.
2) Isotretinoin can also increase the amount of triglycerides (fats) in the blood and may cause elevation of enzymes in the liver. This will cause jaundice, hepatitis and abdominal pain. Patients should limit their intake of alcohol always.
3) Exposure with sunlight should also be limited, as some patients may notice increased sensitivity to sunlight while on isotretinoin.
4) The patient may also feel more easily depressed and for extreme cases, suicidal thoughts may arise. Do watch out for signs and inform your doctor when it gets worse.
5) There might be mild hair loss and join pain or muscle aches, which will occur at higher doses of isotretinoin.
Personally, I have taken accutane for a year, and I admit the treatment did help my acne problem. But as I was planning to get married, I decided to give it up as I worry about issues it may cause if I might have a baby next time. The effects of accutane were not permanent for me though as my acne came back and I had to find other ways of dealing with it!
Although the potential side effects of isotretinoin (accutane) treatment looks worrying, but it is true that it remains one of the most effective and powerful drugs against severe acne. As long as all the necessary precautions are taken, and the patient is safely monitored, it is still one of the best choices of acne treatment by medication.
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