Severe cystic acne frequently leave behind extensive and disfiguring scars that can be as psychologically troubling as the acne itself. Therefore, the American Academy of Dermatology recommends getting severe acne under control to reduce the occurrence and severity of scarring. The oral medication Isotretinoin, which goes by the brand name Accutane, can control acne conditions unresponsive to other topical and oral treatments. Isotretinoin reduces oil production, kills acne-causing bacteria, reduces inflammation and increases cell turnover, which makes it a powerful treatment for severe acne. However, because isotretinoin is associated with several side effects and can cause severe birth defects, the U.S. Food and Drug Administration restricts distribution of the medication and potential recipients must meet certain qualifications.
Step 1
Counsel with your doctor regarding the side effects associated with isotretinoin. The FDA iPLEDGE program requires that each potential recipient of isotretinoin be fully informed about the health risks that can arise with the use of this medication. Possible side effects include headache, blurred vision, dry skin, nosebleeds, nausea, thinning hair and depression. You must undergo a similar counseling session each time the medication is prescribed.
Step 2
Register for the FDA's iPLEGDE pregnancy prevention program through your doctor. He must register all isotretinoin recipients in the computer-based risk management program, including post-menopausal women and men. Your doctor will give you a program ID card with a username. Look for information regarding your program password in the mail.
Step 3
Take two pregnancy tests, if you are a female of childbearing age. The iPLEDGE program requires female recipients who could become pregnant to take two negative pregnancy tests prior to receiving their prescription. Take the initial test in your doctor's office. Take the confirmation test at least 19 days later. The second test must be taken in a CLIA-certified laboratory. Females of childbearing age must take a pregnancy test each month at a CLIA-certified laboratory, before the monthly prescription can be filled.
Step 4
Affirm to your doctor that you will use two forms of birth control if you are woman of childbearing potential. Select two forms of effective birth control and pledge that you will use them both simultaneously for the month before beginning therapy, during treatment and for the month after treatment.
Step 5
Obtain your isotretinoin prescription from a pharmacist registered in the iPLEDGE program. Go to the ipledgeprogram.com website and use the pharmacy finder tool to locate the closest registered pharmacist. Enter your city and state and click "search." You will receive no more than a 30-day supply of the medication at one time.
Step 6
Follow closely your doctor's instructions for dosing. Do not take more or less of the medication, and take it with food or water. The American Academy of Dermatology asserts that most recipients take the medication once or twice per day for a maximum of 20 weeks.
Step 7
Expect your acne condition to worsen initially. The first few weeks of treatment may trigger flare-ups, however finishing the course of your therapy can send severe acne into long-term remission.
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