All About Accutane

In the early 1970s, Accutane (isotretinoin) was approved in Europe for the treatment of acne. A little more than ten years later, the FDA approved it for patients with severe acne. Since then, other clinical forms of acne have also been shown to benefit greatly from the use of Accutane.

Accutane is best absorbed when it is taken with a fatty meal.  The oral retinoid acts upon the sebaceous gland—the main oil glands in the skin. This results in a reduction of sebum (oil) production by up to 90%. As a result, the bacteria is unable to thrive.

The side effects of Accutane may involve dryness of the mouth and nose, generalized dryness, and skin tenderness. Hair loss and dermatitis occur less frequently.

Muscle aches are the most common neuromuscular complaint seen with Accutane use. They occur in approximately 15% of patients on therapy.

The issue of Accutane and psychiatric effects has received a great deal of publicity lately. From 1982 to May 2000, 37 cases of suicide, 110 cases of hospitalized depression, suicidal ideation or suicide attempt, and 284 cases of non-hospitalized depression were reported to the FDA’s Adverse Event Reporting System. This requires careful review of the patient for signs and symptoms of depression and suicidal ideation when Accutane therapy is considered.

Recently, questions about a link between isotretinoin use and development or exacerbation of inflammatory bowel disease (IBD) have been debated.   Several lawsuits have been filed against pharmaceutical companies and individual prescribers. IBD is believed to result from a genetic susceptibility awakened by an environmental trigger; usually occuring in patients in their 30’s. The researchers found that isotretinoin use was rare in young IBD patients before IBD diagnosis and that isotretinoin use was neither more nor less prevalent in IBD patients than in the general population.

Accutane is a teratogen, an agent that interrupts or alters the normal development of a fetus, with results that are evident at birth. There is a serious potential complication when Accutane is used in women of childbearing age. In an effort to eliminate the risk of pregnancies while taking Accutane, the FDA has established a mandatory registry (I-Pledge) for all prescribing physicians, dispensing pharmacists, and patients receiving isotretinoin in the US.

While isotretinoin has received much bad publicity about side effects as of late, it is overall an extremely safe and effective medication for patients with severe forms of acne.  I believe isotretinoin to be both safe and extremely effective in the treatment of severe acne. If you or a loved one suffers from acne, there are many options available. We are pleased to evaluate your unique condition.

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