Oral isotretinoin treatment

The magic bullet so often held out to teenagers (and older people) with skin problems is the controversial medication "isotretinoin" - marketed under the brand name of Roaccutane / Accutane.

This product was developed to help clear up deep cystic acne, but it has become the vogue to prescribe the medication, since some incorrectly prescribe it as a cure-all, and some prescribe it for financial gain, as the cost of this medication is high.

Although the efficiency of the medication for severe (with the emphasis on severe) recalcitrant nodular acne is not disputed, it does have some unwanted side effects, which according to the product insert includes the following:

• Fetal malformation
• Risk of spontaneous abortion
• Liver toxicity
• Psychiatric disorders including:
  • Depression
  • Psychosis
  • Suicidal ideation
  • Suicide attempts
  • Seizures
• Benign intracranial hypertension which must be referred to a neurologist
• Corneal opacity
• Elevation of high density lipoproteins and elevation of cholesterol levels
• Diabetes
• Inflammatory bowel syndrome
• Hyper pigmentation
• Hair thinning and alopecia.

Apart from these, some other side effects have also been reported by people using this oral treatment:

• Dry skin
• Eczema
• Photosensitivity
• Sweating
• Nail dystrophy
• Lethargy
• Back pain
• Epilepsy
• Headaches
• Skin fragility
• Liver dysfunction
• Nosebleeds
• Dry mouth and nose
• Sore, cracked and sensitive lips
• Conjunctivitis
• Blurred vision
• Nausea
• Irritability
• Decreased concentration

The above lists would be enough to scare off most people, yet people that suffer the agony of acne may go to any lengths to find a cure.

And it does help with severe recalcitrant acne, the manufacturer states very clearly that they do not fully understand why the active ingredient - a synthetic stereoisomer of all-trans retinoic acid - helps with the condition.

This statement alone leaves a feeling of quiet discomfort, since the learned researchers should after all these years (the medication was first formulated in 1971) have been able to find out why this highly controlled, yet over-prescribed medication does what it is suppose to do.

People of all ages get acne, but it is more prevalent in Caucasian people aged between 12 and 24, although this can extend into the 30 to 40 year old age groups.

Before people with acne consulted a dermatologist, they have normally tried a variety of topical (applied to the skin) over-the-counter medications, which could include a variety of active ingredients, from benzoyl peroxide, salicylic acid to sulfur - and these preparations normally sort out the problem.

Some of these over-the-counter medications can also cause side effects, such as skin irritation, redness etc and care should also be exercised when using them.

People suffering from acne must keep a few simple things in mind:

• If you are suffering from severe cystic acne - see a dermatologist.
• Use a good facial wash that will assist in keeping the skin clean. Rather stay away from harsh soaps and scrubs, since although you may feel that the stronger the soap the better the result, it is really the opposite that is true.
• Do not pick, squeeze or pinch the blemishes - you could cause scars.
• If you shave - do so carefully and make sure that you soften the beard properly with warm water and a mild soap before using your shaving foam - it causes less stress when shaving since the beard is softer.
• Do not suntan - although it may temporarily hide the redness and blemishes, sun tanning can have a negative influence on some skin medications (topical and oral) and can cause permanent damage and premature ageing.
• Choose your skincare range with care - the skincare range should be formulated for problem skin, and should not excessively dry the skin. People suffering from acne have the mistaken idea that the more drying a product, the better the result in clearing up the acne. This is not true - you still need to moisturize and protect - so keep away from oily or greasy products but look at products that will provide your skin with the essential moisture.
• Keep make-up to a minimum. Although most people would like to hide acne under layers of base and foundation, it is the worst thing that you can do.
• A regular visit to a beauty salon (for both women and men) should also be considered, where a trained therapist would be able to gently tend to the skin, and use products formulated to assist in clearing up skin problems.

In closing, let us make it very clear that we at Dermaxime think that Roaccutane (Accutane) can be a most helpful drug to assist with problematic acne, but that the prescribing of this potent drug, must be done with great care, and only for people who really need it.

Other information on acne and pimples

We have divided the pages dealing problem skin into various categories, which you can access by following the hyperlinks below.

• General information
• Age groups affected
• Terms used in acne
• Age groups affected by acne
• Prevention and treatment of acne scars
• Acne medication - over-the-counter and prescription
• Treating acne with Isotretinoin (Roaccutane / Accutane)
• Facts and myths about acne
• Social behavior and psychological effects of acne and pimples
• Where acne is found on the body