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What is Accutane?
Accutane is a systemic retinoid drug used to treat severe, scarring acne. Systemic means it is taken as a pill and retinoid means it has many of the same benefits on acne that Retin-A has such as decreasing oiliness and removing blackheads. Accutane is usually reserved for a patient who has not responded well to topicals such as Retin-A cream or antibiotic creams like benzoyl peroxide or clindamycin. It should be used as a last resort after topical creams have not worked.
Will my scars go away after Accutane?
If the acne is just beginning to scar, Accutane can prevent the scarring associated with nodulocystic acne but Accutane cannot repair the scars if the acne has been present for a while. Laser resurfacing can be performed to improve the scars a year after completing Accutane.
How long will I have to take Accutane?
The typical course of therapy is five months and one pill is taken in the morning and at night.
Will the acne come back after I finish the Accutane?
Acne may return but in a milder form that can be treated with Retin-A cream or other topicals. It is unusual for scarring acne to recur but it does happen and a second course of Accutane may be necessary. This is more common in patients who skip doses or who do not complete the entire five months of therapy.
What are some of the side effects of this drug?
There are side effects that occur in almost everyone including dry skin, dry, chapped lips, dry eyes and nosebleeds. These can be minimized with the use of Cetaphil, Aquanil....Eucerin...Pureblend...Aquapho for lips, Ocean nasal spray and Artificial Tears. Sun sensitivity also occurs in most people so it's important to avoid the most intense time of the day (9 am to 4 pm) and wear a hat, sun protective clothing and sun protective lotions such as topical Vitamin C serum and Vitamin E lotion.
Another side effect in most people is poor wound healing. Do not plan elective surgery for at least six months after stopping Accutane because the scars may not be acceptable. As noted above, laser resurfacing for acne scars should be postponed at least a year after the Accutane is stopped.
Babies born of women taking Accutane frequently have severe birth defects.
Some less frequently encountered side effects are depression, elevation in blood lipids like triglycerides and elevation of liver tests which can signal liver damage, muscle aches, severe headaches and swelling of the brain.
What will I need to do while taking Accutane?
Your physician will recommend at least two types of contraception and counsel you about not taking Accutane if you intend to become pregnant. You will also need to have blood tests to check for liver function and blood lipid elevations each month while you are taking Accutane. You will be registered in the IPledge program to ensure your safety. If you become sad or depressed while taking Accutane, stop the drug and call your physician.
Are there alternatives to this drug?
Speak to your physician about alternative therapies. Some lasers and light therapies can improve acne and the scarring that occurs later. There may also be complementary therapies such as vitamins, minerals and herbs that can improve this condition. Bromine is a common additive in bleached flour products and soft drinks and these should be avoided by anyone with acne, since bromine causes acne.
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