The National Institutes of Health notes that isotretinoin, known by the brand name Accutane, is most commonly used to treat extremely severe and disfiguring acne. It is taken by mouth in capsule form. It should only be used after other acne medicines, including antibiotics, have not resulted in improvement, due to the risk of serious side effects. Treatment lasts 15 to 20 weeks, and may result in total and prolonged resolution of acne in many patients.
Uses
In addition to treating severe acne, isotretinoin can be prescribed for a bacterial infection of the skin on the face called folliculitis; a sweat gland problem called hidradenitis; and rosacea, a skin condition characterized by red, thickened skin of the nose and cheeks. It can also treat disorders resulting in thickened and patchy skin, such as palmoplantar keratoderma and keratosis follicularis.
How It Works
Isotretinoin is in a category of medications called retinoids, and is a form of vitamin A. It works by slowing the production of sebum secretion, reducing the amount of oil produced by sebaceous glands in the skin. Isotretinoin also speeds skin cell turnover to help skin renew itself more quickly. These actions prevent dead skin cells and bacteria from building up in the pores and causing acne.
Common Side Effects
The most commonly reported side effects include abnormal hair growth, bleeding and redness or swelling of the gums, menstrual flow changes, dry, peeling or cracked lips and skin, dry mouth and eyes, inability to wear contact lenses, dizziness, dry nose that can result in nosebleeds, fatigue, thinning hair, headache, nervousness, difficulty sleeping, and temporary worsening of acne.
Serious Side Effects
Serious side effects include sudden numbness or weakness on one side of the body, sudden and severe headache, difficulty hearing, convulsions, severe pain in the upper abdomen, nausea and vomiting, rapid heartbeat, dark urine, yellowing of the skin or eyes, severe diarrhea, bloody or tar-like stools, fever and chills, easy bruising or bleeding and broken bones.
Isotretinoin may cause severe psychiatric side effects such as depression, psychosis, suicidal thoughts or behavior and severe aggression and violence. A doctor should be notified immediately if any serious side effects occur.
Warnings
Isotretinoin must not be used by female patients who are pregnant or might become pregnant due to the significantly high risk of serious birth defects. Possible birth defects include abnormalities of the skull, brain, face, eyes and ears. Increased risk of miscarriage and premature births result from use during pregnancy. The FDA requires patients to participate in a program called iPLEDGE intended to prevent this serious risk. The program requires mandatory actions such as providing two negative pregnancy test results prior to treatment and again each month, using two forms of birth control and seeing the prescribing doctor monthly.
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