Isotretinoin, popularly known as Accutane, is a prescription drug used to treat severe acne that hasn't improved through the use of other drugs such as antibiotics (clindamycin, doxycycline, etc.) or topical steroids (hydrocortisone, etc.). The typical treatment of Isotretinoin lasts between 4-6 months for most patients with patients taking a daily dose based on their weight and the severity of their condition; those with more severe acne tend to be under treatment for longer, lasting up to a year. Isotretinoin is usually used as a last resort for acne treatment due to the high amount of side effects and health risks that come along with the drug.
How Isotretinoin Works and Its Benefits
Targeting the underlying cause of severe acne, Isotretinoin works by significantly reducing the size and activity of sebaceous (oil) glands in the skin, which in turn decreases the production of sebum—a key factor in acne formation. Not only does Isotretinoin target oil production, but it also targets clogged pores, inflammation, and bacteria, making it effective in its treatment against severe acne. Isotretinoin may prove to be life changing for those who have tried many creams, antibiotics, and treatments with little to no success. Many patients experience a substantial reduction in breakouts and scarring over the course of many months, which frequently results in clear skin even after therapy is finished. As one of the best treatments for those with cystic, recurring acne, Accutane is worth the attempt for some due to the improvement in their self-confidence and overall quality of life.
The Risks and Side Effects
Despite its effectiveness, Isotretinoin has a range of potentially dangerous side effects. Extremely dry skin, chapped lips, and joint pain are common problems, but more serious dangers like mood swings, liver damage, and birth defects need to be monitored closely. Patients undergo frequent blood tests and follow-up appointments with their dermatologist during treatment because of these potential issues. Because of a greater likelihood of birth defects, women in particular need to follow strict guidelines, which includes using birth control methods. Because of the severity of these side effects, dermatologists only prescribe Isotretinoin when the benefits exceed the potential risks.
Different types of side effects
Common side effects: dry skin, chapped lips, dry nasal passages (which may lead to nosebleeds), headache, bone or joint pain, dry eyes, thinning hair, etc.
Serious side effects: Pressure in brain (blurred vision, nausea, vomiting, seizures, stroke), increased cholesterol and triglyceride levels, liver problems including hepatitis, blood sugar problems (diabetes), decreased night vision, ear ringing or hearing loss, and pancreatitis (inflammation of the pancreas).
Birth defects cause by Isotretinoin: small or missing ears, hearing loss, microphthalmia (small eyes), missing eyes, and cleft plate.
Long-term side effects: blood sugar and blood fat level problems, sexual dysfunction, and organ damage.
Mental health side effects: irritability, sadness, depression, psychosis, and suicidal thoughts.
Who should consider it?
Making the choice of starting Isotretinoin treatment should not be taken lightly because it will need months of monitoring, controlling side effects, and following strict regulations. Nonetheless, Accutane can provide a long-term solution that is challenging to find elsewhere for those who have run out of other options. Ultimately, deciding whether to take Accutane or not depends on how one chooses to weigh its potential for change against any potential drawbacks. Patients can decide if beginning on the path to clear skin is worthwhile with the guidance of a qualified dermatologist.
Sources
Pietrangelo, Ann. “What Are the Side Effects of Isotretinoin (Accutane) on the Body?” Healthline Media, 18 Mar. 2016, https://www.healthline.com/health/accutane-side-effects-on-the-body#mental-health-side-effects. Accessed 22 Aug. 2024.
Isotretinoin: The truth about side effects. (n.d.). Retrieved August 22, 2024, from https://www.aad.org/public/diseases/acne/derm-treat/isotretinoin/side-effects
https://www.ncbi.nlm.nih.gov/books/NBK525949/#:~:text=Isotretinoin%20is%20an%20oral%20prescription,conventional%20therapy%2C%20including%20systemic%20antibiotics. Assessed and Endorsed by the MedReport Medical Review Board