Acne treatments vary greatly from inexpensive creams to powerful pills. For most people, traditional acne treatments such as benzoyl peroxide or antibiotics are effective. Unfortunately, this may not be the case for people with severe cases of acne, particularly cystic acne. Roaccutane, or isotretinoin, is a potent drug that is reserved for treating severe cases of acne.
Function
Roaccutane is one of the brand names for the drug isotretinoin. Isotretinoin shrinks the sebaceous glands, or oil glands, in the skin, which leads to an improvement in the complexion. Isotretinoin reduces skin bacteria as well, which reduces inflammation. According to the American Academy of Dermatology's AcneNet website, isotretinoin is highly effective at treating severe acne because it is the only acne treatment that treats all of the factors that contribute to acne, such as excess oil production, bacteria, clogged pores and inflammation.
Significance
Acne that hasn't responded to other medications and disfiguring cystic acne are ideal candidates for isotretinoin treatment. Isotretinoin is occasionally prescribed for other severe skin conditions such as folliculitis and rosacea. Isotretinoin is a retinoid, which means it's derived from vitamin A, and is the most effective treatment available for severe acne. Most people who complete one course of isotretinoin treatment experience full remission of their acne without needing repeated treatments. Isotretinoin can prevent additional permanent scarring in individuals with scarring cystic acne.
Usage
A course of treatment with isotretinoin typically lasts about 16 to 20 weeks. The medication is taken as a pill either one or twice daily. According to Mayo Clinic, women who are of childbearing age must register with the iPLEDGE program. This keeps track of women who are taking isotretinoin due to the high possibility of severe birth defects. Women of childbearing age are also required to take a pregnancy test and start two reliable forms of birth control for one month before beginning treatment.
Side Effects
Side effects associated with isotretinoin use can be severe. Temporary side effects that subside as treatment progresses include skin crusting, dryness of the eyes, nose or mouth, increased sun sensitivity, mild headache and mild stomach upset. More serious side effects include bone or joint pain, eye inflammation, difficulty moving, lip inflammation and skin rash. Rare but serious side effects include abdominal, stomach or back pain; blurred vision; depression; jaundice; severe headache; and behavioral changes, including suicidal ideation.
Contraindications
Women who are pregnant or planning for pregnancy should not take isotretinoin. The possibility for very severe birth defects is very high with isotretinoin treatment. Patients should consult with a physician before beginning any prescription or nonprescription medications as well as supplements, to prevent drug interactions. Additionally, certain medications and supplements reduce the effectiveness of hormonal birth control. Patients with a history of depression or suicidal ideation should be monitored closely.
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