Struggling with Acne: 5 Things You Should Know About Accutane

Acne can be frustrating at any age, and often it can be difficult to treat simply with topical products. If you’ve made the decision to seek help from a board-certified dermatologist, well done. You’ve already taken an important first step in the journey toward clear skin. Too many rely on the advice of online health and beauty gurus who don’t fully understand the complexities of the human skin, how conditions can vary by person and what treatments are needed for each individual.

Types of Acne

Before getting into the implications of any treatment plan, it’s important to quickly review the different types of acne you may experience. Acne may be inflammatory or non-inflammatory, including blackheads, whiteheads, papules, pustules, nodules or cysts. It’s possible to have more than one type of acne at once. 

Non-inflammatory acne consists of blackheads and whiteheads, and normally doesn’t cause swelling. Blackheads (also called open comedones) appear on the skin as black dots when a pore is clogged and the interior skin cells and bacteria are exposed to the skin. Whiteheads (also called closed comedones) are raised from the skin as a white bump, since the top of the pore is closed up. 

Inflammatory acne, on the other hand, refer to pimples that are red and swollen and can be deeper under the skin, and much more difficult to treat topically. 

What to Consider if You’re Thinking About Isotretinoin (aka Accutane)

Severe acne can have a devastating impact your self-esteem and confidence. If considering Accutane, it’s likely because you’ve tried a variety of other treatments that haven’t done the trick. 

Accutane is the brand name for the medication Isotretinoin, although there are a number of generic versions available under different names. Isotretinoin is a retinoid taken orally, and is a synthetic derivative of vitamin A. While the results have stunned many who have undergone treatment, it isn’t a medication to consider lightly. It is a potent prescription medication with stringent eligibility and monitoring guidelines for doctors and their patients. 

Here are five things to consider if you’re thinking about starting isotretinoin.

It is only recommended for those with severe acne or scarring.

It’s generally agreed upon that isotretinoin should be considered a last resort if all other treatments and medications have not worked. It’s only recommended for those suffering from severe, nodular acne that hasn’t responded to oral antibiotics and other topical treatments. If all else fails, it’s worth giving this a try for a more permanent solution. 

You will need to actively manage side effects like harsh dryness.

Accutane works to reduce the amount of oil that the sebaceous glands produce, and therefore you’ll experience excessive dryness in your skin, eyes, lips and nose. You’ll need to layer on plenty of moisturizer, keep eye and nose drops readily available, and lip moisturizer — like Aquaphor — on hand. Your skin may also be extra sensitive during and after treatment, meaning you will require extra SPF to prevent burns and sun damage during any duration of sun exposure. 

You will be required to get regular blood tests.

As part of the treatment, patients will need to get a blood test prior to starting and then regularly each month throughout treatment. Isotretinoin can increase a user’s blood cholesterol, lipids, triglycerides and abnormal liver enzymes. Levels are monitored very closely to ensure that a user’s body is tolerating the medication well and that they are not at risk at any point.

If you are a woman, you should not begin treatment if you are pregnant or planning to become pregnant.

If you are pregnant or planning to become pregnant, you should not consider beginning treatment and your doctor will not move forward with treatment. This is because one of the known side effects of isotretinoin is birth defects. With this knowledge now in hand, those enrolling in this treatment program must register with the iPLEDGE online program. 

iPLEDGE is a risk management system that aims to prevent pregnancy in patients taking isotretinoin. Women of childbearing age must commit to using two forms of birth control while taking isotretinoin, beginning at least one month before starting treatment and continue until at least one month after treatment. They must have two negative pregnancy tests before beginning treatment, which will be part of the blood test completed at initial registration and before the first round of medication is given. A pregnancy test is also completed along with the blood test each month before a patient can fill their prescription.

Your skin may get worse before it gets better.

During the treatment, you may look in the mirror and see adverse effects before improvement. Don’t panic. Your acne may get worse temporarily before it gets better. To help treat this side effect, your doctor may prescribe an additional medication, like an antibiotic, to go with the treatment. Patients usually report that their acne clears up within the first couple of months. 

If you are frustrated with persistent and severe acne, the best first step is to consult a board-certified dermatologist to review your options. A doctor can help tailor a treatment plan specifically for you and, if needed, explore isotretinoin as a course of action. 

Give Buckhead Dermatology in Atlanta and College Park a call to learn more about how we can help you with your skin health needs.