If you have severe acne that has not responded to standard treatments, you may be desperate to try any option that can help heal your skin. Isotretinoin, which is sold under the brand names Sotret, Claravis, Amnesteem, and formerly sold as Accutane, may seem like a miracle cure. But for some people the health risks may outweigh the potential benefits. Women who are pregnant or may become pregnant SHOULD NOT take isotretinoin.
Acne is formed when skin oils and dead skin cells block the openings of pores in the skin. The blocked pore can become inflamed and may form white or blackheads, which are called comedones. Some types of acne form open sores or pimples on the skin. Other types form cysts or nodules under the skin. Severe acne can cause serious, permanent scarring. Treatments for acne include medications to reduce skin oil production to prevent comedones from forming.
Isotretinoin is one of a group of medications called retinoids which are similar to vitamin A. It is available only by prescription and is taken by mouth as a capsule. Isotretinoin is typically only prescribed when other treatments have failed. It works by reducing the amount of oily sebum that is produced by the sebaceous glands in the skin. Less oil means less chance pores will become blocked, which means less chance that pimples will form. Reducing the number of pimples can reduce the amount of scarring. Many people who use isotretinoin have dramatic improvement in the condition of their skin after 15 to 20 weeks of treatment.
While isotretinoin may seem to be a miracle drug for people with some types of acne, there can be severe and even life-threatening side effects.
• Pregnancy – Isotretinoin is known to cause birth defects in a developing baby if mom takes the drug while she is pregnant. Women who are pregnant cannot start the medication. Women who are of childbearing age must use two effective types of birth control the entire time they are taking isotreninoin, starting one month before taking the drug and continuing a full month after stopping the drug.
• Mental health – Isotretinoin may increase the symptoms of depression and other mental health issues include suicidal tendencies. This may happen while taking the drug or after ending the acne treatment.
• Headaches – Isotretinoin may cause headaches accompanied by nausea, vomiting and blurred vision.
• Liver problems – Isotretinoin may cause changes in liver function resulting in jaundice and pain in the abdomen.
• Vision issues – Isotretinoin can reduce tear production which causes eyes to be red, dry and itchy. It can also increase night blindness by making it harder to see the contrast between black and white.
Because of the high risk of birth defects, the FDA has created the iPLEDGE website. Prescribing physicians and dispensing pharmacies are required to log information on the website about isotretinoin use. The site also has more information about the drug to help you make an informed decision before you chose to use it to treat your acne.
Because of the potential for serious side effects, do not take isotretinoin unless it has been prescribed for you by your doctor. Be sure to report any side effects and follow all instructions carefully.
Sources:
PubMed Health. Isotretinoin. Web. August 15, 2011.
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000532/
About.com: Teens. Acne FAQ. Web. August 15, 2011.
http://parentingteens.about.com/cs/acne/l/blacne8.htm
MedicineNet.com. isotretinoin, Sotret, Claravis, Amnesteem, (Accutane is no longer available). Omudhome Ogbru, PharmD. Web. August 15, 2011.
http://www.medicinenet.com/isotretinoin/article.htm
About.com: Dermatology. Treatment of Acne With Isotretinoin - Accutane. Heather Brannon, MD. Web. August 15, 2011.
http://dermatology.about.com/cs/isotretinoin/a/accutane_2.htm
iPLEDGE. iPLEDGE: Committed to Pregnancy Prevention. Web. August 15, 2011.
https://www.ipledgeprogram.com/
Reviewed August 16, 2011
by Michele Blacksberg R.N.
Edited by Jody Smith