Treatment of Acne With Isotretinoin - Accutane
Isotretinoin (Accutane) is a medicine that revolutionized the acne treatment. Accutane belongs to the family of medicines called retinoids, which are similar to vitamin A. Accutane, like other retinoids, works by altering DNA transcription. This affect decreases the size and output of sebaceous glands.
also makes the cells that are sloughed off into the sebaceous glands less sticky, and therefore less able to form blackheads and whiteheads (comedones).
Isotretinoin (Accutane)also reduces the number of bacteria in the sebaceous gland and on the skin surface.
Who Takes Accutane?
Accutane is generally used for nodular, pustular acne that has not responded to full courses of several oral antibiotics. The trend in Accutane prescribing for acne has been towards using it earlier in the course of the disease, especially if there is significant scarring. While
Accutaneis used in acne treatment, it has also been used for other disorders such as psoriasis, lupus, and lichen planus, with varying degrees of success.
Starting Therapy With Accutane (Isotretinoin)
Several dosing regimens are used, but the most common regimen involves starting with a low dose, then increasing the dose after several weeks. The length of the acne treatment course varies but generally lasts from 16 to 20 weeks. Some people notice that their acne gets worse after starting Accutane therapy. The number of acne lesions usually does not increase; rather the lesions may become redder or more painful. This is normal, lasts only a short while, and is not a reason to stop using Accutane.
Birth Defects With Accutane (Isotretinoin)
The side effects of Accutane have been a controversial topic. The most noticeable, serious, side effect is its teratogenicity. This means that Accutane causes birth defects if women take it while they are pregnant. The birth defects Accutane (Isotretinoin) causes include central nervous system, facial, cardiac, and thymus gland abnormalities. After Accutane acne treatment has been completed for one month, a woman can get pregnant without worry about birth defects. Accutane (Isotretinoin) does not affect fertility, or make it difficult to get pregnant. Women who are taking Accutane (Isotretinoin) should use two forms of birth control starting a month before treatment and continuing one month after treatment.
Finishing Therapy With Accutane (Isotretinoin)
A standard course of acne treatment is 16 to 20 weeks. At the end of 16 weeks, about 85% of patients are clear. The beneficial effects of Accutane (Isotretinoin) do not stop when the drug is discontinued. A further reduction of acne lesions and improvement of scarring is seen for months after acne treatment has stopped. Another beneficial affect of Accutane (Isotretinoin) is that after a course of the drug, the skin usually responds better to conventional acne therapy.
Final Thoughts About Accutane (Isotretinoin)
The side effects of Accutane (Isotretinoin) acne treatment have prevented some people from considering it as a viable therapy. However, the majority of side effects go away after the drug is discontinued with the notable exception of the birth defects. Despite its side effects, Accutane (Isotretinoin) remains the most powerful and promising therapy for moderate to severe acne. Used in a prudent manner, with careful monitoring, it can change the life of an adolescent or young adult.