Accutane(Isotretinoin) fights acne and enables your skin to restore back to normal. Learn about its effects and possible adverse reactions you may experience  during treatment.

Accutane is a remedy commonly prescribed in the management of relentless cystic acne (sometimes called nodular acne). According to American Academy of Dermatology, it can clear severe acne that fails to improve with any other remedy. Healthcare experts will advise you to resort to this drug in cases when oral antibiotics (e.g. clindamycin, tetracycline) or topical agents such as benzoyl peroxide have brought you no healing benefit. This drug falls into a class of retinoids. It ensures the protective effect by diminishing the production of facial skin oil (sebum). At uncontrollably high levels, sebum brings about sever or extreme acne that may leave your skin permanently scarred.

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Retinoids may make you vulnerable to sunlight. Limit your exposure to sun rays. Refrain from using sunlamps and solarium booths. Cover yourself with clothing and put on sunscreen when going outdoors. Inform your doctor without delay if you get sunburns or your skin develops rash/blisters.

Dosing schedule

Adult use

Appropriate starting dose for acne in adults is 0.25 mg/kg per oral route twice a day. This should continue for as long as needed (maintenance dosing). The regular dose may be calibrated to 0.5, with the maximum reaching up to 2 mg/kg daily. Proceed with the therapy for no longer than 20 weeks.

Pediatric use

For children from 12 years and older, the same dosage and adjustment rules apply. Make sure that you measure the child’s body weight carefully and calculate the dose accordingly.

General considerations

Swallow drug capsules intact, without crushing or chewing them. Therapy usually requires 15-20 weeks or as established by your MD. Both brand version and generic forms are normally taken with meals. The only exception is the Absorica brand for which FDA has established that patients may dose  it regardless of feeding. Nutritious substances promote absorption of this medicine from your gut into the bloodstream. Swallow the pill accompanied by a glassful of water, and retain the erect pose for a minimum of 10 minutes after the intake.

Side effects

Dry and peeling lips are the most often observed adverse effect. Its severity depends on the dose and is reported by about 90% of acne patients. Dry skin and parched mouth, bothersome dryness in the nose, and sensitivity to sunlight are also very common. Sunlight protection and a choice of skin moisturizers should be considered before proceeding with the medication. Avoid all skin resurfacing routines (laser therapy, waxing, scrubbing) during treatment and for a minimum of half a year afterwards so as not to risk scarring and irritation.

Troubling symptoms

Discontinue Accutane and contact your MD the moment you observe:
  • disturbances in vision and/or hearing;
  • sore spots in your muscles or joints, deep bone pain, vertebral pain;
  • unquenchable thirst, increased urination;
  • seeing or hearing people or things that cannot be real.

Dangerous symptoms

  • uncontrollably changing mood – unusual mood swings, crying spells, abnormally low self-esteem, disinterest to things you once relished, unprecedented sleep problems, thoughts about harming yourself;
  • severe discomfort in your stomach – strong stomach pain or chest pangs, painful swallowing, pyrosis, loosened bowels, rectal bleeding, bloody or pitchy stools;
  • increased pressure inside the skull – strong headaches, tinnitus, dizziness, morning sickness, vision impairment, pain behind your eyeballs.

Dangerous symptoms

In the majority of patients, the recommended doses work as expected. Your acne may be exacerbated during the first few days of therapy, and a full period of 1-2 months may be required before any noticeable improvements. If you suffer a case of returning acne, an additional course of treatment may commence only after a pause of two months. The manufacturer advises against administering isotretinoin in long terms.