Effective Acne Treatment

Comes With Costs

Experienced pediatrician examining patient face

Experienced pediatrician examining patient face

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Isotretinoin entered the dermatologist’s medicine cabinet in 1982, when it was approved as the brand Accutane. Today, the oral retinoid-based medicine is offered under other brands, including Amnesteen and Claravis.

This is serious treatment for serious acne. It’s extremely effective because it addresses all of the root causes, including the extreme levels of inflammation. Over the last 36 years, millions of acne sufferers have had their severe acne clear up. That said, patients need to be fully aware of certain considerations and side effects.

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Here is what to consider before taking isotretinoin:

• Pregnancy: Isotretinoin can interfere with fetal development, resulting in birth defects. The FDA requires both doctors and patients to participate in a program called iPLEDGE. For women of childbearing age, this includes using two forms of birth control and pregnancy testing.

Liver: check-ups will be required to monitor liver enzymes and lipid levels, as they can be affected.

Depression: Some patients have reported that isotretinoin caused depression or inflammatory bowel disease. At this point, research hasn’t established a clear link with either. This year, the AAD reaffirmed its support for isotretinoin, as long as patients are aware of the possible risks and doctors monitor the situation.

Lower back pain is sometimes reported.

Vision change may occur.

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Dry skin: During treatment, isotretinoin can dry out the skin and cause sun sensitivity. Don’t wait for problems to occur. From the start of treatment, patients should moisturize daily and drink plenty of water, as well as use sunscreen abundantly.

• Acne flares: Don’t be alarmed if at first your acne flares: In some cases, patients see an initial spike in their symptoms. You can also talk with your doctor about starting off at a lower dose to acclimate.

Follow your doctor’s instructions. For example, for optimal absorption, it’s important to take it with a full meal. Patients are advised to not take over the counter vitamin A when taking Isotretinoin.

Stopping early will likely cause a relapse: Isotretinoin is extremely effective at clearing up acne but a goal of treatment is also to hopefully prevent any reoccurrence. The research here is quite clear: patients need to reach a certain level of cumulative medication. A patient who stops early is more likely to have a relapse.

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Jie Chen, RPA-C is a board certified physician assistant with Advanced Dermatology PC and the Center for Laser and Cosmetic Surgery (New York and New Jersey). She has a master’s degree in physician assistant studies.
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