Accutane and Acne
Isotretinoin is an acne medication available in generic form and several brands, including Accutane. All isotretinoin medications are available only by prescription. Since it can cause serious side effects, isotretinoin is usually prescribed only for severe cases of acne, but physicians may also prescribe it for more moderate cases. Accutane is effective at treating nodular and cystic acne even when the condition has not responded to other therapies.
Acne usually results from excess oil production preventing dead skin cells from sloughing way, which then accumulate and block pores. These blocked pores create an environment where anaerobic bacteria that cause acne can grow. Nodular acne involves inflamed, solid, swollen lumps under the skin surface, and they can be very painful. A person with severe cystic acne has large pus-filled cysts, inflammation and extensive damage to the skin surface.
Both nodular and cystic acne can last for years and leave permanent scars. Cysts and nodules often occur together, a condition called nodulocystic acne. These severe forms of acne require aggressive therapy, according to the American Academy of Dermatologists (AAD), and sometimes isotretinoin is the only effective treatment.
Accutane is a synthetic retinoid (form of Vitamin A) available in tablets and capsules. The medication shrinks oil glands, thus decreasing oil production, preventing blocked pores and inhibiting bacterial growth, which reduces inflammation. Isotretinoin can result in remissions that last for years, according to the AAD. Many patients only need one course of treatment, typically lasting 16 to 20 weeks. Patients usually are advised to take Accutane twice a day with food and a full glass of water.
The U.S. Food and Drug Administration (FDA) requires a warning on Accutane and other isotretinoin product labeling because the drug causes severe birth defects that may lead to infant death. Accutane also causes miscarriages and premature birth. To obtain a prescription for Accutane, an individual must participate in a program called iPLEDGE designed to prevent pregnancy. Women must have two consecutive negative pregnancy tests before they can acquire a prescription, and must have a pregnancy test every month while taking Accutane. They must also use two effective and different types of birth control during this time frame. Men also must participate in the iPLEDGE program to obtain an Accutane prescription.
Another FDA-required warning states that Accutane can cause depression, psychosis and suicidal thoughts and action. Accutane is associated with many other side effects as well. These include dry eyes and a significant decrease in night vision, which may be permanent. Some patients have developed cataracts while taking isotretinoin. Rarely, Accutane use may lead to inflammatory bowel disease, liver damage, kidney disease, and an increase in pressure of the fluid around the brain.
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