Accutane: A Long-Term Answer for Severe Acne

Many people do not understand how acne can affect a person's self esteem. Acne can become so serious as to inhibit a person's social life and self worth. If you have gone to your doctor in search of treatment for acne and have received Accutane, the following information pertains to you.

What is Accutane, and how does it work?

Accutane (Isotretinoin) is used to treat a type of severe acne (nodular acne) that has not been helped by other treatments, including antibiotics. Four to five months of Accutane treatment usually leads to clearing of acne. Acne is caused by inflammation of the skin. It usually affects teenagers, but it also affects adults. Severe acne causes permanent scarring of the skin. The inflammation is mostly caused by an increase in secretion of sebum (oily substances) from glands in the skin (sebaceous glands). The sebum triggers inflammation, and the inflammation heals with the formation of a scar .This is known as keratinization. If less sebum is secreted it is likely that there will be less inflammation and keratinization. The Food and Drug Administration approved isotretinoin in 1982.

Who should NOT take Accutane?

If you are pregnant, DO NOT take Accutane. If you're planning to become pregnant, avoid this medicine. Only take Accutane if you completely understand the possible risks and are willing to follow the specific directions that are included in the Medication Guide that the doctor is supposed to give you.

What is the dosage for Accutane, and how should I take it?

The usual recommended dose of isotretinoin is 0.5 to 2 mg per kg of body weight daily. The daily dose usually is administered in two divided doses for 15-20 weeks. A woman will never receive anything more than a 30 day supply of Accutane. Each month that a woman is going to refill her prescription, she must have a negative pregnancy test, enter her two types of birth control into the iPLEDGE system (by phone or by the Internet), and sign an additional patient consent/information form. Your prescription should have a special yellow self-adhesive sticker affixed to it. The sticker is always yellow. If your prescription does not have this yellow self-adhesive sticker, call your doctor or pharmacist. The pharmacy should not fill your prescription unless it has the yellow self-adhesive sticker. You will take Accutane 2 times a day with a meal, unless your pharmacist/doctor tells you otherwise. Always swallow the Accutane capsules with a full glass of liquid, followed by food. This will help prevent the medication inside the capsule from irritating the lining of your esophagus (connection between mouth and stomach). For that very same reason, do not suck or chew on the capsule. If, for any chance, you miss a dose, just skip it. Never double up on the dosing.

How do Physicians and Pharmacists dispense Accutane?

Physicians and pharmacist must follow a new set of rules called "iPLEDGE." This new program has been recently announced by the FDA. The iPLEDGE program requires that everyone involved with Accutane, whether it be those who prescribe, suppliers, or users of the drug, be registered and be willing to accept certain drug responsibilities. For woman who are of child-bearing age, the responsibilities including actually registering with iPLEDGE, signing an informed consent form in your physicians office, obtaining two negative pregnancy tests within seven days before starting this drug (these pregnancy tests can only be administered under the doctors supervision), and the woman has to agree to use two forms of birth control. If a man is going to use Accutane, he also has to sign an informed consent form and register through his doctor's office, but they don't have to sign up with iPLEDGE.

What should I avoid while taking Accutane?

While taking Accutane, it is severely important that you do not get pregnant. Accutane dangerously increases the risk of birth defects and death in unborn children. Do no breastfeed while taking Accutane, or for one month after you're finished with the medication. It is not known if it's possible for Accutane to pass through a mother's milk to the child. It's better to be safe. Also, you can't give blood while you're on Accutane and for a month after stopping the use of Accutane. If a pregnant woman receives your donated blood, her baby may have birth defects. Since Accutane is mostly Vitamin A, don't take Vitamin A supplements. Vitamin A in high doses has pretty much the same effect that Accutane has. Taking both Accutane and Vitamin A together increases the side effects to a great degree. If you're thinking about having a cosmetic procedure done to smooth your skin, or if you're thinking about waxing, dermabrasion, or laser procedures while taking Accutane, do not do it. Your chances of scarring from these procedures become very high while on Accutane. One of the side effects of Accutane if photosensitivity. To avoid this side effect, stay away from sunlight and ultraviolet rays as much as possible. This includes tanning beds and artificial UV lights. Please refrain from sharing Accutane with other people. Since they are not properly informed, registered, and educated on the drug, they will not be fully aware of the side effects. As you already know, you may be exposing your friend to the side effects and possible birth defects if that person gets pregnant. If you are taking an antibiotic, talk to you doctor about this before taking Accutane. The simultaneous use of these drugs causes increased brain pressure, which could cause a tremendous amount of pain.

What are the possible side effects of Accutane?

Accutane can cause chilitis (swelling of the lip due to inflammation), conjunctivitis, dry skin, pruritus (an itching sensation), dry mouth, dry nose, arthralgia (pain in the joints), rash, thinning of the hair, upset stomach, fatigue, headache, photosensitivity and thoughts of suicide. Accutane has also been associated with a number of cases of pseudo tumor cerebri (cranial hypertension). If you every feel any severe headaches, nausea, vomiting, and/or visual disturbances, consult your doctor immediately. Be referred to a neurologist for further diagnosis and care.

For the right person, Accutane can make a powerful, positive difference. Initially, the acne will usually get worse during the initial weeks of therapy. Thankfully, dramatic improvement typically follows. The results are very long-term and for some, the side effects and extra precautions as far as pregnancy goes are worth it. Good luck with your Accutane, and remember to follow all the instructions. A few months from now, you'll begin to see a new you emerge, and your long battle with acne will finally come to an end.