Dr. Jennell Nelson - MD
 

What is Accutane (Isotretinoin)?

Accutane is the gold standard of treatment for acne. Typically patients start with topical treatments, then progress to oral treatments. The next step is chemical peels, laser treatments or photo-dynamic therapy. Hormonal therapy like birth control pills and aldactone can be very helpful treatments for acne. If all else fails Accutane works.

What are some concerns for Accutane (Isotretinoin)?

Accutane has gotten a lot of negative press because of the effect that it has on unborn fetuses. It is true that accutane should not be taken during pregnancy because of the severe deformities that will occur. The child will most likely be incompatible with life. This is a valid concern.

Another concern is the link between accutane and depression. There was a politician’s son that committed suicide while taking accutane. It is unclear if the depression was a result of the acne, a pre-existing condition or the drug itself. Needless to say this brought a lot of negative media attention to the drug. This led to the FDA iPledge Program. A service that closely monitors the physicians, pharmacies and users to ensure that accutane is taken the way it is prescribed.

The third and final concern is inflammatory bowel disease. This is typically a genetic disorder but can be unmasked by Accutane use.

How is Accutane taken, what does Accutane do?

Accutane is derived from vitamin A or isotretinoin. It is ingested into the body and delivered through the blood stream into the hair follicles. The significant thing about accutane is that it significantly shrinks the oil glands permanently and changes the DNA of the sebaceous gland to prevent the clogged pore component of acne.

A typical course of accutane will last six months. Women have to take pregnancy tests while both men and woman have to consent to blood tests that are done monthly. If you quit the Accutane prior to a 5-6 month course, it will come back. Finish the entire course to ensure your cure.

What are some side-effects of Accutane?

Within two weeks patients should notice a significant reduction of blemishes. Side effects like dry lips and dry skin are expected.  We monitor headaches, dizziness, blurry vision and upset stomach. We will always ask about mood swings and/or depression. The end goal in dosing acctane is to increase the dose by the second month and continue treating until the patient no longer breaks out. By the time the course has expired they should be free of acne. If the patient has not cleared by six months, their course may be extended.  If after you stop accutane 6 months course the acne returns within 4-6 months, then a second course is recommended. This rarely happens.

What to expect after stopping Accutane? 

70-80% of patients never get acne again 20% of patients may have to take a second or third course. Rarely a very small % of patients don’t respond fully to Accutane.  In those cases, hormonal and cosmetic therapy can be instituted for opitmal control.  Accutane is not a new drug and has been used safely and effectively since the 1970's for millions of acne sufferers.

ACCUTANE (ISOTRETINOIN) BEFORE AND AFTER PICTURES