As discussed in a previous post, systemic antibiotics are usually used to treat severe acne to avoid spread of infection and to prevent scars from forming on the acne lesions. Antibiotics are powerful drugs in themselves but if acne remains uncontrolled, it is time to call in the heavyweight of all acne medications. Enter isotretinoin.
Isotretinoin, also known by one its brand names accutane, is the most potent severe acne treatment product out there. It is a synthetic form of Vitamin A and is taken orally for serious acne cases that have not responded to other medications.
It will often cure acne for good but has many side effects and therefore requires close medical supervision to use. However, with the exception of birth defects, most of these adverse effects disappear when the drug is discontinued.
About 25% of patients who took isotretinoin may have a relapse. In such cases, a follow-up therapy may be given.
- Marketed as Accutane®, Amnesteem®, Sotret®, or Claravis®
- Must be taken for 4-6 months for it to take effect
- Usual dosage is from 0.5 mg/kg/day to 2 mg/kg/day; recent studies indicate that using lower dosages may be just as effective while reducing the chances of side effects
- Initially, acne may seem to get worse
- Unlike most other treatments, it strikes at the root of acne, by decreasing the size and oil production of the sebaceous glands
- Also makes the cells that are sloughed off less sticky, and therefore less able to plug the pores and cause blackheads and whiteheads
Its common side effects include:
- dry, itchy, or easily-injured skin
- abnormal hair growth or hair loss
- bleeding gums
- dry & red eyes, which may prevent patient from wearing contact lenses
- decreased night vision
Serious potential side effects of isotretinoin include the following:
- yellowing of the skin or eyes, indicating liver damage or pancreatitis
- swelling of the optic nerve
- increased blood triglyceride levels
- birth defects in developing fetus; for this reason, isotretinoin is not suitable for pregnant women