Accutane is the brand name of an oral medication called isotretinoin and is used to treat severe acne that doesn’t respond to other treatments. Accutane works by doing something no other acne medication can do. It alters your DNA and, in doing so, it reduces oil production from the sebaceous glands, regulates the skin cells in the follicle, reduces inflammation of the skin and decreases the amount of bacteria on the skin.
Accutane for acne
Accutane is intended to the treatment of severe, acne that is not responsive to other treatments. It is often referred to as a “last resort” drug for those who suffer from acne. Many patients try treatment with oral antibiotics, as well as in-office procedures such as Isolaz laser or photodynamic therapy, prior to starting isotretinoin.
Accutane for acne is typically taken for a course of approximately six months. It is a pill that is usually taken once or twice daily with food. Some patients notice improvement immediately, while some patients actually notice that their acne gets worse before getting better. Most patients see an improvement in their acne by the third or fourth month of treatment. Most patients do very well after taking a full course of Accutane, with about 95% responding very well. Accutane is a weight-based medication, meaning that a course of Accutane is completed once the patient has taken a certain amount of medication per pound of weight. Patients who complete the appropriate dose usually do very well. Unfortunately, there are still a very small percentage (about 5%) of patients who do not experience clearance of acne after taking Accutane. Of the 5% of patients who do not clear from one course of Accutane, 50% will clear from a second course.
The cost of prescription Accutane can vary. Depending on where you obtain your prescription from, the cost can be up to $300. It’s best to consult with your dermatologist at your appointment to learn about how much Accutane will cost.
Accutane side effects
Some patients experience an initial acne flare when starting to take Accutane but most do not. This can be avoided by starting Accutane at lower doses and increasing the dosage slowly. When started on a low dose, few patients experience an initial flare. The vast majority of patients do not experience any major side effects while taking Accutane. The most common side effect is excessive dryness of the skin and lips. Patients may find that their lips and skin are very dry; we recommend using moisturizers and emollients on the lips (Vaseline works very well) and body regularly to address this issue. Other, much less common, side effects of Accutane include gastrointestinal issues and mood changes. These side effects are rare but can be potentially serious, and it is very important to contact your doctor immediately if you feel you are experiencing side effects from Accutane. Alcohol should be avoided while taking Accutane. A possible side effect of Accutane is liver complications. Since alcohol is known to damage the liver, the combination of alcohol and Accutane could be twice as harmful to the liver. Accutane makes your skin more sun sensitive, so regular sun protection and avoidance of excess direct sunlight is recommended.
The most common side effects of Accutane include:
- Eye irritation
- Joint pain
- Dry mouth
- Skin peeling
- Sun sensitive skin
Accutane long term side effects
The long term side effects of Accutane have been widely talked about in the media. One of the long term side effects that has received a lot of publicity is a link to birth defects. For this reason, female patients must wait one month after finishing Accutane before trying to conceive. Each month, female patients will have a pregnancy test prior to starting their next Accutane prescription. There is a final pregnancy test that is administered one month following the last dose of Accutane. For some patients, Accutane is a “cure,” meaning that they never have acne again. They still get occasional pimples, but they don’t get severe breakouts like they did prior to taking Accutane. For some patients, they are clear for many years after taking Accutane, but they do flare at some point in the future. The good news is that after taking Accutane, most patients respond better to conventional acne medications and do not need to restart Accutane. Some patients do not experience clearance of their acne while taking Accutane, but this is the minority of patients. Most patients do very well after Accutane treatment.