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Isotretinoin for acne vulgaris
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Isotretinoin for acne vulgaris
Table of Contents
Isotretinoin for acne vulgaris
Isotretinoin is a powerful and effective medication used to treat severe acne that cannot be cleared up with other medications, including antibiotics. It is a synthetic retinoid, which is derived from vitamin A. Isotretinoin usually needs to be taken for 3 to 6 months.
How It Works
Isotretinoin works by unclogging skin pores and shrinking oil glands.
Why It Is Used
Isotretinoin is used to treat people who:
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● Have severe acne that does not get better with other treatments.
● Develop scars (particularly deep scars) after their pimples or cystic lesions heal.
How Well It Works
In most people, acne goes away or improves within 4 to 5 months after starting isotretinoin medication.
Studies have shown that isotretinoin is more likely to control acne when it is given to older versus younger teenagers. If acne returns after you stop using isotretinoin, it usually is not as bad as it once was. However, a second course of isotretinoin is needed in about 20% of those treated.1
Retinoid medications may have side effects, such as:
● Miscarriage and serious birth defects.
The most dangerous side effect of retinoid
medication is miscarriage and serious birth defects in babies whose mothers took the medication during pregnancy. Women who can have children need to take special precautions so that they do not become pregnant while they are taking retinoid medication. The risk of birth defects and miscarriages goes away about 1 month after the medication is stopped.
● Increase in triglycerides in the blood.
A person who takes retinoid medication may
have higher-than-normal levels of certain fats (triglycerides) in his or her blood. High levels of triglycerides may make a person more prone to certain health problems, such as heart disease. For this reason, all people need to have their blood checked for triglyceride levels before starting this medication and every 4 to 6 weeks while taking it.
● Changes in mood or thoughts.
The Center for Drug Evaluation and Research
division of the U.S. Food and Drug Administration (FDA) warns that Accutane may cause depression, psychosis, and, rarely, suicidal ideation, suicide attempts, and suicide. The link between Accutane and these mood changes is not clear. Talk to your doctor for more information on whether Accutane is right for you or your child. If you or your child are taking Accutane and have signs of depression, see your doctor for treatment. Discontinuing Accutane may not reverse depression.
● Liver damage.
Some people who have certain liver conditions may develop liver
damage if they take retinoid medication. For this reason, all people need to have blood tests to check their liver function before starting this medication. People with liver problems need to have blood tests to check their liver function during treatment with retinoid medication.
● Other side effects.
Other common side effects of retinoid medications can include
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chapped lips, dry skin, dry eyes, and dryness inside the nose and mouth. People also complain of fatigue, sensitivity to the sun, problems with night vision, and thinning of hair.
For more information on isotretinoin, see Drug Reference. (Drug Reference is not available in all systems.)
What To Think About
Isotretinoin is strictly regulated for use in women by the U.S. Food and Drug Administration (FDA) because of the danger of miscarriage and serious birth defects in babies whose mothers took the medication during pregnancy. Health professionals may only prescribe these medications for a woman who is not pregnant and who does not intend to become pregnant while taking the medication.
See a list of questions to ask your doctor about medications.
1. Cunningham BB, Fallon-Friedlander S (2003). Disorders of the hair
and hair follicles. In CD Rudolph, AM Rudolph, eds, Rudolph's Pediatrics, 21st ed., pp. 1208–1215. New York: McGraw-Hill.
Primary Medical Reviewer
Specialist Medical Reviewer
Randall D. Burr, MD
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