Accutane – What is it and what to expect? By Christine Read

Christine Read

Accutane (Isotretinoin) is a medication that is used to treat severe acne or acne that has not responded to other acne treatments. It is a vitamin A derivative that works by decreasing oil production and changing oil glands in the skin. Most of the time, oil production permanently decreases, which lowers the risk of acne returning long-term. 

Accutane is a very effective medication, and it must be closely monitored by your healthcare provider. Accutane can be associated with side effects, the most serious of them all is birth defects. Females that are pregnant or trying to get pregnant cannot take this medication. In 2005, the FDA created an online monitoring program to make sure females are not and do not get pregnant while taking Accutane. This is enforced with monthly pregnancy tests for all females.

Dry skin, dry lips, dry nose and dry eyes are the most commonly associated and expected side effects of Accutane. It is important to stay hydrated and use moisturizer and ChapStick while taking Accutane. Patients taking Accutane are also highly sensitive to the sun, so sunscreen is an absolute must! 

There have been several studies done evaluating the association of Accutane with increased depression or suicidal ideation. More recent studies have shown that there is not a direct correlation with increased depression in patients that are taking Accutane. Some studies reveal that patients taking Accutane may have overall improved depression and decreased suicidal thoughts. Because this is a serious condition, the side effects of emotional lability, depression and anxiety are monitored closely throughout the course of Accutane.

Gastrointestinal side effects have also been reported with Accutane, such as nausea, abdominal pain, constipation, and blood in the stool. The serious side effects, such as inflammatory bowel disease, ulcerative colitis and Crohn’s, are a consideration. However, there has been no definitive causal relationship between Accutane and these inflammatory bowel diseases.

Accutane can also cause mild flaring when patients start taking the medication. The dose and course of Accutane is curated to fit each patient’s needs as well as type and degree of acne. 

Laboratory work is required while taking Accutane. Liver function and triglyceride levels are monitored while on Accutane because Accutane is processed through the liver. The frequency of the lab work done is determined by your healthcare provider. Visits with your provider are required every month since Accutane can only be prescribed as a 30-day supply, as mandated by the governing program.

Accutane is a serious and closely monitored medication, and side effects should always be discussed with your provider. Accutane really helps to not only treat and cure acne, it also can change a person’s life by improving the appearance of their skin and in turn improving overall self-esteem.

Author
by Christine Read, PA-C

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