Learning about Accutane

Many dermatology patients have either severe/scarring acne or acne that is just “stubborn/resilient” despite aggressive treatment. For these patients, the ideal treatment is an oral drug called Isotretinoin. Most of the public know this drug better by the name Accutane. Accutane was created and marketed for decades by Roche Pharmaceuticals. However, interestingly enough, the “name brand” Accutane is no longer available. Instead, new formulations of the same medication have been developed. For the purposes of discussion, however, I will use the name “Accutane” b/c of its familiarity. Accutane is an extraordinary medication for acne as well as some other medical conditions. It is the one medication that virtually always produces an excellent outcome for troublesome acne. Accutane is usually taken for about 6 months. Once the patient finishes treatment, he or she is usually “cured for life”. Occasionally, patients relapse later and require another course of Accutane, but this is uncommon.

Accutane is an extraordinary medication for acne as well as some other medical conditions. It is the one medication that virtually always produces an excellent outcome for troublesome acne.

Accutane sometimes gets negative coverage because it has one major side effect that is incredibly important : if a woman gets pregnant WHILE TAKING ACCUTANE, the baby can have a birth defect. This is ONLY TRUE if the pregnancy occurs DURING treatment. Future pregnancies are not affected by the drug. However, due to this important reality, the use of Accutane is monitored by a Federal program knows as the I Pledge Program. Both patients and providers are involved in following this program which is designed to prevent pregnancy during the use of Accutane. Accutane has a few EXPECTED/PREDICTABLE side effects that occur during treatment. One of these is LIP CHAPPING. Lip care is important during the patient’s course of treatment. In addition, some other side effects occasionally occur. Though these are not “dangerous”, they can be frustrating. These possible side effects include (but are not limited to)

• joint pain,
• sun sensitivity,
• dry skin
• dry eyes and
• nosebleeds.

They occur in a minority of patients. A very small percentage of patients can experience important side effects that must be addressed. Examples of these include:

• severe headaches,
• mood swings and
• depression.

Though these effects occur rarely, they are important and require dose reduction or discontinuation of the medication. The VAST majority of patients experience no side effects whatsoever (other than lip chapping). In extremely rare cases, a patient’s liver or lipids can be affected by Accutane, so we do perform some routine blood tests during treatment. All that being said, the providers in our practice have treated thousands of patients with Accutane over the past couple of decades and have had virtually no “major” problems using the medication. We think it is a fabulous medication when indicated, and several of our providers have utilized Accutane in our own children. This is indicative of how much confidence we have in this medication.