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.