A Review of Isotretinoin (Accutane) for Acne Treatment

Are the severe and numerous risks worth the benefits?

Isotretinoin is a prescription drug intended for severe nodular acne. Results are often short-lived and acne returns within a week or two after the end of therapy. Acne symptoms caused by environmental allergens such as ingredients in body care and cleaning products and chloracne caused by dioxins cannot be controlled with isotretinoin therapy. For detailed information about the causes of acne, please read, "What Causes Acne?" Although isotretinoin therapy can control the production of sebum associated with acne during treatment, when treatment ends the environmental antagonists remain, and the acne returns.

Isotretinoin is a prescription drug intended for severe nodular acne. However, according to many reports, such as Use of isotretinoin (Accutane) in the United States: Rapid increase from 1992 through 2000, this drug is being heavily prescribed for moderate acne. In some cases, this drug is also being prescribed for mild acne that has not responded to other methods of controls. Sold under the brand names of Accutane, Amnesteem, Claravis, or Sotret, there are well over 2 million prescriptions written for isotretinoin. In addition, black market internet sales cannot be calculated.^[1]

There are incredible risks associated with isotretinoin. Severe birth defects, including clef palette and severe brain damage, are the most well known side effect. Liver function tests are required during therapy to monitor damage to the liver during the course of treatment. Other side effects are known that can have a life-long impact requiring medical care for the lifetime of the patient such as the following list of Accutane's Harmful Side Effects from YourLawyer.com. I was skeptical that all these horrible conditions are potential side effects from this single drug. However, the Roche documentation on Accutane supports every single one of these conditions as a potential side effect from this drug. There is actually one side effect missing from this list; hearing loss. Imagine never being able to hear your mother tell you she loves you again.

Here's the list of potential adverse reactions to Isotretinoin (Accutane, Amnesteem, Claravis, or Sotret):

Inflammatory Bowel Disease which includes: Crohn's Disease, Ulcerative Colitis, Proctitis, Enterocolitis, Ileocolitis, Ileitis, Rectal Bleeding, Sigmoiditis, Colitis

Musculoskeletal Disease which includes: Premature epiphyseal closure, Desiccation of the spine & dessicated discs

Vision Damage: Optic neuritis, Cataracts, Conjunctivitis, Corneal opacities, Keratitis, Papilledema, Blindness

Liver Damage: Cirrhosis, Hepatotoxicity, Hepatitis

Central Nervous System: Pseudotumor Cerebri (false brain tumor, can lead to blindness), Seizures, Stroke, Paralysis

Pancreas: Pancreatitis Hemorrhagic Pancreatitis, Hypertriglyceridemia

Immune System Disorder: Lupusm Rheumatoid Arthritis, Multiple Sclerosis, Connective Tissue Disorders, Wegener's Granulomatosis, Agranulocytosis, Diabetes, Hodgkin's Disease, Inflammatory Bowel Diseases, Lymphadenopathy, Neutropenia

Kidney Disease: Glomerulonephritis, Hyperuricemia (Gout), Proteinuria, Rhabdomyolysis, Kidney Stones, Urogenital conditions, Hypercalcaemia

Cardiovascular Injuries: Arteriosclerosis, Calcification of coronary arteries, Calcification of mesenteric arteries, Calcification of poulmonary arteries, Fibrosis of the myocardium, Inflammation of the myocardium, Palpitations - Tachycardia, Vascular thrombotic disease, Vasculitis, Ventricular tachycardia, By Pass surgery

Skin Dieases: Acne fulminans, Alopecia, Bruising, Cheilitis, Dry mouth, Dry nose, Dry skin, Epistaxis, Eruptive xanthomas, Flushing, Fragility of skin, Hair abnormalities, Hirsutism, Hyperpigmentation, Hypopigmentation, Infections, Nail dystrophy, Paronychia, Peeling of palms and soles, Photoallergic/photosensitizing reactions, Pruritus, Pyogenic granuloma, Rash - including facial erythema, seborrhea, and eczema), Sunburn susceptibility increased, Sweating, Urticaria, Vasculitis - including Wegener's granulomatosis, Abnormal wound healing - delayed healing or exuberant granulation tissue with crusting

Psychiatric Diseases: Suicide and Suicidal Thoughts, Depresssion, Aggression, Psychosis

Birth Defects: New evidence is showing that birth defects may be paternal as well as maternal. In addition, the risks associated with birth defects by isotretinoin may be for the life of the patient rather than just during the course of treatment.

Internal Birth Defects: CNS abnormalities (including cerebral abnormalities, cerebellar malformation, hydrocephalus, microcephaly, cranial nerve deficit), cardiovascular abnormalities, thymus gland abnormality, parathyroid hormone deficiency

External Birth Defects: Skull abornormality, ear abnormalities (including anotia, mircopinna, small or absent external auditory canals, eye abnormalities (including microphthalmia), facial dysmorphia, and cleft palate^{[9, 10]}

Social and environmental costs associated with isotretinoin are incalculable at this time.

Summary

Isotretinoin is the highest risk, including death, suicide, potential life-time risk of bearing deformed offspring and, should those offspring reproduce, the potential for their offspring to suffer abnormalities is not known at this time. The increased social costs for potential long-term adverse reactions is incalculable at this time. The increased risks for long-term, and potentially generational, costs of health maintenance of deformed offspring is incalculable at this time. The environmental fate of isotretinoin is unknown at this time. It is not known if isotretinoin can be removed from the waste stream prior to environmental release at this time. It is not known if there is the potential for isotretinoin to survive the disinfection process of public water supplies and be returned to public drinking water at this time.

To learn other treatment options for your acne, such as antibiotic treatment, chemicals such as glycolic acid, salicylic acid and benzoyl peroxide treatments and holistic treatment please visit: http://www.sunflowernaturals.com.

Resources:

1. Use of isotretinoin (Accutane) in the United States: Rapid increase from 1992 through 2000, http://www.accutaneaction.com/Press/AAD2002UseofIsotretinoin.pdf

2. Accutane's Harmful Side Effects,http://www.accutanelawyernetwork.com/index.html3. Roche, Accutante, Isotretinoin capsules, http://www.rocheusa.com/products/accutane/pi.pdf