Isotretinoin is the generic name for a vitamin A derivative with a number of medical applications. It is best known as a treatment for severe, disfiguring nodular or cystic acne. It was originally designed as a cancer treatment and still sees some use in that area, as well as for more obscure medical conditions.

Though Isotretinoin is remarkably effective at clearing up acne, the medication is somewhat controversial due to the severity of side effects associated with its use, particularly birth defects and miscarriage.

This treatment is typically prescribed as a last resort when other treatments, such as antibiotics, have failed to clear up acne. Additionally, acne must be severe enough to pose significant risk of physical scarring or disfigurement.

A Long Term Solution for Severe Acne:

Isotretinoin is very effective for the vast majority of patients. At the beginning of treatment acne may flare up briefly, but within one month most patients will have acne-free skin.

For the most part future acne breakouts will be mild, if they occur at all, even after treatment ends. A small percentage of patients will need to periodically repeat treatment to control severe outbreaks.

The medication is administered in tablet form, usually taken twice a day with food and fluids. Treatment duration is usually a month or two, though in difficult cases it may last up to nine months.

Isotretinoin is also effective on other skin conditions:

• Rosacea - severe rash or reddening of skin on the nose and cheeks.
• Hidradenitis suppurativa - presence of abscesses or cysts on sweat glands on underarms, breasts, buttocks and the groin area.
• Folliculitis - gram-negative bacterial infection on facial skin.
• Thickened or patchy skin - such as from palmoplantar keratoderma or lamellar ichthyosis.

This medication is also sold under the brand name Accutane.

A Word on Adverse Effects:

As mentioned above, Isotretinoin is a somewhat controversial treatment due to the side effects associated with its use. This is not a complete list of potential adverse effects; patients are strongly encouraged to discuss Isotretinoin use with a physician as well as read the documentation included with the product prior to using.

Isotretinoin is most infamous for causing severe physical and mental birth defects, as well as miscarriage. The medication may be present in the body for up to one month after the last dose was taken, and is also present in semen. Males and females both should avoid unprotected sex for the duration of treatment and for one month after treatment ends.

Patients should not donate blood during treatment or for one month after treatment ends, as the even trace amounts of Isotretinoin present in blood may cause birth defects or side effects in an unsuspecting recipient.

Some patients develop inflammatory bowel disease, or Crohn's disease, while taking Isotretinoin. Though it remains unclear exactly what role, if any, the drug plays in this disease, some patients have successfully sued Isotretinoin manufacturers for damages related to inflammatory bowel disease in U.S. courts.

Depression and suicidal thoughts is another side effect associated with this medication, though again the relationship between the drug and the disorder is unclear. Some independent studies indicate Isotretinoin plays no role in depression.

It is also believed Isotretinoin may inhibit bone growth in teenage users.

For U.S. Customers:

Due to the potential for miscarriage or severe birth defects, U.S. FDA regulations require patients residing in the U.S. to participate in the iPLEDGE program for the duration of Isotretinoin treatment and for one month after treatment ends.

U.S. clients who purchase or use Isotretinoin without participating in the iPLEDGE program do so at their own risk and may be in violation of FDA regulations.