How Isotretinoin (formerly Accutane) Works – Acne

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Isotretinoin (previously sold under the brand name Accutane) is the drug that revolutionized acne treatment. (Other brands include: Claravis, Amnesteem, ABsorica, Myorisan, Zenatane, and Sotret).

Isotretinoin belongs to a family of drugs called retinoids, which are similar to vitamin A. Isotretinoin, like other retinoids , works by altering DNA transcription. This effect reduces the size and volume of the sebaceous glands .

This drug also makes the cells that separate from the sebaceous glands less sticky and therefore less capable of forming blackheads and whiteheads (comedones). In addition, it reduces the amount of bacteria in the sebaceous glands and on the surface of the skin.

One of the downsides to isotretinoin is that it comes with many serious side effects (as well as some less serious, but still bothersome), so be sure to weigh the pros and cons with your doctor before deciding if this drug is the right treatment. .. the choice is yours.

Applications

Isotretinoin is commonly used for nodular pustular acne that cannot be treated with full courses of various oral antibiotics. The trend in the prescription of isotretinoin for acne has been its use at an earlier stage of the disease, especially if there are significant scars.

Although isotretinoin is used primarily for severe acne , it has also been used with varying degrees of success for other conditions such as psoriasis, lupus, and lichen planus .

Before drinking

Before starting isotretinoin therapy, patients should have a blood test to check triglyceride levels, liver function, and a complete blood count. Women should also take a pregnancy test. Periodically, during the course of therapy, but especially one month after the start of therapy, these labs are checked again .

Risk of birth defects

The side effects of the drug have been a controversial topic. The most notable and serious side effect is teratogenicity. This means that isotretinoin causes birth defects if women take it during pregnancy. Birth defects caused by isotretinoin include abnormalities of the central nervous system, face, heart, and thymus.

After completing isotretinoin treatment within a month, a woman can become pregnant without worrying about birth defects. Isotretinoin does not affect fertility and does not hinder pregnancy .

Women taking isotretinoin must use two methods of contraception during this period: one month before starting treatment until the end of the first month after finishing treatment.

Dose

Various dosage regimens are used, but the most common regimen is to start with a low dose and then increase the dose after a few weeks. The duration of the course of treatment varies, but generally ranges from 16 to 20 weeks.

Some people find that their acne gets worse at first after starting isotretinoin therapy. Acne lesions generally do not increase, but they may become redder or more painful. This is normal, does not last long, and is not a reason to stop using isotretinoin .

Final therapy

The standard course of therapy is 16-20 weeks. After 16 weeks, approximately 85% of patients recover . The benefits of isotretinoin do not stop after stopping the drug.

A further reduction in acne breakouts and post-inflammatory hyperpigmentation (or discoloration) is seen months after stopping treatment. Another positive effect of isotretinoin is that after a treatment, the skin usually responds better to conventional acne therapy .

Side effects

Isotretinoin therapy can also cause the following less serious but potentially bothersome side effects:

  • Dry skin that requires frequent use of moisturizers.
  • Dry and chapped lips
  • Nosebleeds
  • Itchy skin (itchy skin)
  • Hair thinning
  • Excessive flaking, especially on palms and soles.
  • Muscle aches and pains that are worse with physical exertion.
  • Greater sensitivity to the sun, causing more easily sunburn .
  • Elevated triglyceride levels

Severe form

Isotretinoin therapy also has the following serious side effects:

  • Headaches , if they continue and are accompanied by nausea, vomiting, and blurred vision, may be a sign of a condition called pseudotumor cerebri.
  • The risk of depression, psychosis, and suicide attempt increases during treatment and returns to normal when the drug is stopped.
  • The formation of tears in the eyes is reduced, which can cause red and itchy eyes and possibly ulceration of the cornea, especially in contact lens wearers .
  • The ability to distinguish between shades of black and white can be reduced, resulting in night blindness.
  • Liver enzymes can be elevated and cause jaundice, hepatitis, and abdominal pain .

Get the word of drug information

The side effects of isotretinoin therapy prevent some people from considering it a viable therapy. Despite its side effects, isotretinoin remains the most powerful and promising treatment for moderate to severe acne . Used wisely and carefully monitored, it can make a difference in the life of a teenager or young adult.

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