Acne Treatment Journal

Accutane Frequently Asked Questions
Answers to the frequently asked questions (FAQ) about the powerful anti-acne drug Accutane (Isotretinoin).

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Welcome to my "Accutane Frequently Asked Questions" page. In this section, I'll do my best to address all of your concerns about the warnings, side effects, and results of using Isotretinoin.

Many of the topics on this page have also been covered in my detailed Accutane Treatment Journal.

1. What is Accutane?

A. Accutane is the most well known name brand of the powerful anti-acne drug "Isotretinoin". It is manufactured by Roche U.S. Pharmaceuticals.

The drug is marketed under the name "Roaccutane" in Europe and the rest of the world.

2. What are some of the other available brand names of Isotretinoin and do they work just as well as Accutane?

A. Some of the other generic brands of Isotretinoin that compete with Roche's Accutane brand are Amnesteem, Claravis, Sotret, Isotane, Oratane, and Decutan.

I took the Sotret brand of generic Isotretinoin made by Ranbaxy Laboratories for 4 months of my 6 month treatment. I found it to work just as well at a much lower cost per pill.

3. How does Isotretinoin work to clear up my face?

A. Isotretinoin is classified as a "retinoid" which is a derivative of Vitamin A and is naturally found in the body in very small amounts. At larger doses, Isotretinoin combats all four major causes of severe acne vulgaris. These four causes are the increased production of sebum at puberty, changes in the cells lining the hair follicles, increase of the P. Acnes bacteria on the skin, and hormones called androgens.

Isotretinoin helps the skin cells inside your hair follicles and facial pores to normalize their production, which keeps pores from clogging and pimples from forming. Isotretinoin also reduces the amount of sebum that the sebaceous glands produce, and slows the growth of the Propionibacterium acnes bacteria.

4. Who should take Isotretinoin?

A. Because of the many side effects, possible health risks, and expensive treatment costs, Isotretinoin is usually reserved for people who suffer from severe acne vulgaris. Someone with severe acne would have multiple deep cystic acne nodules that can be painful and cause scarring. Accutane is often considered a last resort after all the wide variety of topical medications and oral antibiotics have failed to control the patient's acne.

5. Who should not take Isotretinoin or handle the pills?

A. Pregnant women, or females who intend on becoming pregnant should not take or even touch Isotretinoin pills. The drug is not known to be mutagenic (won't cause mutations) but it can cause an unborn fetus to develop a variety of birth defects.

Some of the possible birth defects include mental retardation, heart defects, undersized head, malformed ears, cleft lip, eye abnormalities, and facial deformation.

Women who are sexually active and plan on taking Accutane or any other brand of Isotretinoin should consider using two forms of birth control to prevent pregnancy.

Mothers who are breastfeeding might also want to avoid taking Isotretinoin since it is unknown what effect the small amounts of Isotretinoin contained within the breast milk may have on a developing baby.

6. What are the most common side effects of Isotretinoin?

A. I personally experienced dry eyes, dry lips, dry scalp, dandruff, a rash on my hands & arms, the inability to wear my contacts while sleeping, and an increased sensitivity to the sun's UV rays.

Some of the other common side effects include joint pain, muscle pain, feeling drowsy, feeling dizzy, nausea, vomiting, headaches, fatigue, exhaustion, increased sweating, peeling skin, mood changes, hair loss, nose bleeds, trouble concentrating, dry nose, itchy skin, dry skin, and decreased night vision.

7. What are the rare but possible severe side effects of taking Accutane?

A. If you experience any of these severe side effects while taking Isotretinoin, stop taking the medication and seek medical attention. Some of the rare but possible severe side effects of Isotretinoin include depression, thoughts of ending your life, vision problems, seizures, yellow eyes, yellow skin, dark stools, hives, an all over rash, vomiting, numbness of the arms or legs, impaired hearing, persistent diarrhea, high fever, loss of appetite, abdominal (stomach) pains, bleeding from the rectum, and chills.

8. What kind of results can I expect while taking Isotretinoin?

A. From what I've experienced and also read in other people's Accutane journals, you can expect for your acne to get worse before it gets better. Most people go through the dreaded "initial breakout" at around the two week mark. After that it should be smooth sailing with your skin looking clearer every day with less new pimples appearing. You'll be less concerned with blemishes and more worried about finding products to alleviate the myriad of side effects.

9. Which products or methods work best to combat the side effects of Isotretinoin?

A. For the overall dryness, drink lots of water. For joint pain, take a glucosamine & chondrotin supplement. For dry eyes, always keep a bottle of Visine Moisturizing drops or saline "tears" in your pocket and use it frequently. For dry skin, use Cetaphil moisturizing lotion for your body and Neutrogena Sensitive Skin SPF 15 Moisturizer for your face. For dry lips, I prefer the Natural Ice SPF 15 moisturizing lip balm during the day and Aquaphor Healing Ointment at night. For dry scalp, use Nizoral A-D or any other dandruff shampoo about once a week and use a moisturizing shampoo the rest of the time. For any mild rashes, use a cortisone anti-inflammatory cream. For the skin's increased sensitivity to sunlight, use a non-comedogenic (won't clog pores) daily moisturizer with at least a sun protection factor (SPF) of 15 and any Neutrogena brand SPF 30 or 45 sunscreen for extended sun exposure. To combat the fatigue, exhaustion or drowsiness, try to get some light exercise at least a few times a week.

10. How should I take my Isotretinoin pills and what other precautions should I keep in mind?

A. It's best to take your pills with a meal to avoid any nausea, stomach cramps, or vomiting. Isotretinoin absorbs into the body better when taken with food, which will help it be more effective. If you miss a dosage, just skip it and take your next scheduled pill on time. Do not take two pills because you forgot about the last one. Do not take antibiotics with Isotretinoin unless your doctor specifically approves. Do not take Vitamin A supplements with Isotretinoin since this anti-acne medication is a close chemical relative of Vitamin A and you could suffer a Vitamin A overdose. Don't give blood while taking Isotretinoin because if your blood is given to a pregnant woman, her child may develop birth defects. Avoid drinking alcohol while taking Isotretinoin because this combination may damage your liver, which is already working hard because of the medication.

11. What are the long term side effects and results of Isotretinoin?

A. Almost all of the side effects that I experienced while taking the Accutane & Sotret brands of Isotretinoin have disappeared.

The only problem that I had while on the drug that is still persisting to this day is the inability to wear my contact lenses while sleeping. My eyes feel normal during the day when I wear my contacts, but if I don't take them out before going to bed for the night or even taking a short nap, I wake up with red bloodshot eyes and the lenses "glued" to my eyeballs.

Everyone reacts to Isotretinoin differently so some people may experience more long term side effects while others may not. It's been a few years now since my 6 month course of the drug and my skin still looks great.

I hope that acne free skin is the only long term effect of Isotretinoin that I'll experience. I plan on having LASIK laser eye surgery on my eyes sometime soon so that I won't have to deal with contacts lenses anymore.

Some of the conditions that I've read can persist or develop from taking Isotretinoin include rosacea (red facial skin), inflammatory bowel disease, keloids (raised red scars), alopecia (hair loss), decreased night vision, arthralgias (joint pain), degenerative disc disease (painful spinal condition), bone disease, and erectile dysfunction (impotence).

All of that may sound scary, but just remember that the majority of Isotretinoin users only experience the most common side effects that are easily alleviated with over the counter products and they generally disappear after you stop taking the drug.

12. Why do I have to go to a medical laboratory every month to give blood for a liver function test?

A. Isotretinoin may cause changes in your body's levels of triglycerides (blood fats), cholesterol or liver enzymes. Too much of an increase can lead to heart disease or liver health risks. A monthly visit to the lab for a blood test is necessary to ensure that your body is not having an adverse reaction to Isotretinoin.

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