Accutane® – the Basics

Accutane® is the original trade name of the generic drug isotretinoin. It is an isomer of Vitamin A acid which, when taken orally, systemically stops the production of sebum throughout the body.

Acne is an inherited disease of the sebaceous follicles – what we call pores – in which the lining of the pores shed too many dead skin cells. These excess dead skin cells form plugs in the pores that mix with and stop up the sebum (oil) produced in the pore, providing a perfect environment for the overgrowth of the p. acnes bacteria, the little critters that live normally in our skin. This combination of excess dead skin cells, too much sebum, and too many bacteria, results in acne lesions — pimples and blackheads.

By stopping the production of sebum, Accutane® takes out one factor in the mix and in most cases will interrupt the production of lesions.

When introduced in 1982 Accutane® really did seem like the magic pill. Take if for four months and your acne will be gone forever!

Oh, if it really were that simple!

The old saying, “if it sounds too good to be true, it usually is,” definitely applies here.

Because it stops the production of sebum systemically, Accutane® creates a whole host of other problems. You can’t dry out all the lining tissue of the entire body without creating some really bad potential problems.

Accutane® Side Effects

Among the side effects are severe birth defects, including mental retardation, if taken by pregnant women or women who become pregnant within a few months of completing it. This side effect is so serious that women of child-bearing age must undergo monthly pregnancy testing and use two forms of foolproof birth control while on it. All patients (male and female) are required to sign a detailed consent form outlining the many severe side effects. Since 2006, all patients who use this drug, all doctors who want to be able to prescribe it and all pharmacies who want to be able to dispense it must join the FDA-mandated iPLEDGE Accutane Registry.

Isotretinoin will cause uncomfortable dryness of skin, lips, hair, cuticles, eyes, and mucous membranes, which can lead to infection in all those areas, including conjunctivitis and cheilitis (acute inflammation of the lips). It can cause the reduced ability to tolerate contact lenses, itching, rosacea, permanent thinning of the skin, permanent skin fragility, rashes, temporary and permanent hair loss, liver damage, kidney malfunction, elevated blood lipids (cholesterol and triglycerides) headaches, back pain, fatigue, joint pain, nausea, vomiting, problems regulating blood glucose levels, decreased libido, erectile dysfunction, cataracts, optic neuritis, papilledema (swelling of the optic disc which can lead to vision loss), impaired night vision, corneal opacities, chronic inflammatory bowel disease, pancreatitis, hepatitis, osteoporosis, degenerative disc disease and interrupted bone growth.

You can’t take it with certain antibiotics. You can’t take it with certain autoimmune drugs and you can’t take vitamin A supplements when you are on it.

While on it patients must undergo a monthly fasting blood test to check for blood lipid levels and kidney and liver damage.

Accutane® interferes with the skin enzyme collagenase, so it increases the risk of severe scarring, which is problematic for individuals who need or want procedures like dermabrasion, deep chemical peels, or laser resurfacing to deal with acne scarring.

The really sad part is that some of these effects take years to manifest. The first patients to take Accutane were teenagers in 1982 so they are only in their forties today. We have no idea what the really long term effects are yet.

So you get the idea that this drug has seriously bad side effects, but how does it do with acne? Well, for some people with unresponsive cystic acne – those people it was developed and intended for – it can be a dream come true, if they are among the lucky ones who get none of the permanent, serious side effects.

Does Accutane® Work?

But you remember I said it works by stopping the production of sebum? Well, acne isn’t caused by an over production of sebum. It is caused first by the shedding of too many skin cells. There are a whole bunch of people with acne for whom excess sebum isn’t a problem. How do you suppose it works for them? It doesn’t.

But a doctor wouldn’t prescribe it for someone like that! Don’t bet on it.

And some folks with oily acne find it returns after they finish the drug. The manufacturer recommends they take a second course. Another four months of Russian roulette with all those side effects plus all those trips to the doctor for blood draws and pregnancy tests! And it still might not work.

In June of 2009, the maker of Accutane® stopped manufacturing and distributing it in the US – they still sell it overseas as Roaccutane – but isotretinoin is still available here from generic drug manufacturers.

Really, there is no magic pill. But usually in less than the same amount of time that Accutane® requires, The Acne Treatment Center can work with you and clear your acne with no dangerous side effects, no blood draws, no pregnancy tests. You will have clear, healthy skin and you won’t wonder what ugly surprise is waiting for you down the road.

©2011 Jane Neville Dudik; The Acne Treatment Center;