Isotretinoin is a treatment for severe acne that has failed to respond to other therapies. The medication is marketed under a number of brand names including Absorica and Myorisan, but is best known as Accutane.
Serious acne sufferers can develop nodules or cysts deep in the skin of the face, back and chest. These acne nodules are hard and painful and can persist for months. Cysts are nodules that have filled with pus. When the two conditions occur together, this type of acne is referred to as nodulocystic acne. Nodulocystic acne doesn’t usually respond to over-the-counter acne medications and can eventually lead to scarring.
Isotretinoin is a powerful acne medication for the treatment of nodular acne. An estimated 85 percent of patients report skin improvement after a single treatment course.
Although effective, the potent medication isn’t right for everyone. Your dermatologist may not prescribe Isotretinoin if you have a compromised immune system, allergies or if you are pregnant, breastfeeding or plan to become pregnant.
Before taking Isotretinoin, your dermatologist will talk with you about side effects associated with the drug, including the risk of birth defects. Both male and female patients must agree to follow the iPLEDGE program to prevent pregnancy. Patient responsibility includes:
- Signing an informed consent form
- Agreeing to keep all appointments
- Adhering to the iPLEDGE program
Female patients following the iPLEDGE program are expected to use 2 forms of approved birth control together, have routine blood or urine pregnancy tests before starting Isotretinoin and each month prior to filling the prescription and one month after the final treatment, and keep all scheduled dermatology appointments.
Once the iPLEDGE requirements are satisfactorily met, a one-month supply of medication will be dispensed each month throughout the course of treatment. Your dermatologist will determine the treatment course length as well as the dosage that is right for you. Typically, Isotretinoin treatment courses are between 4 to 5 months and dosage is 1 or 2 capsules daily.
Your dermatologist will monitor your health closely during this time and instruct you to immediately report any serious side effects including:
- Mental health changes such as depression, thoughts of suicide or psychosis
- Severe headache
- Blurred vision
- Nausea or Vomiting
It is important to avoid waxing for hair removal throughout treatment and up to 6 months after, since this can cause scarring. Isotretinoin also increases the skin’s sensitivity to sun, so patients are advised to take precautions against sunburn and avoid indoor tanning. Do not donate blood while on Isotretinoin or for 30 days after stopping treatment.
When Isotretinoin is taken correctly and responsibly, many patients experience positive results. If you suffer from severe nodulocystic acne, talk with your dermatologist about treatment recommendations.