Accutane (Isotretinoin/Roaccutane), the Powerfully Effective, but Controversial Drug
How does Accutane work so well against acne in so many cases?
Because it accomplishes several things simultaneously that no other medicine can do all at the same time:
reducing oil production (sebum) by reducing sebaceous glands,
decreasing cell build up leading to whiteheads or blackheads,
killing acne bacteria deep inside the skin, and
Normal oil production in your skin will return when you complete your Accutane course. The sebaceous glands will slowly grow larger in size, but will never reach their original size.
Accutane is generally prescribed for stubborn moderate to severe or nodular acne that is resistant to several different treatments. It can quickly reduce severe acne inflammatory lesions by 90%. ( Source: Journal of the American Academy of Dermatology, November 2001, Supplemental, pages 188–194).
But dermatologists remain careful with who they give a prescription to. It is not a true “cure” and to date there is no cure available for acne, only treatments.
For the remaining users where accutane does not work the first time around, they may be recommended to wait for about 6 months before they try a second course of Accutane. If their acne returns after the second course, the drug has likely failed. For 10% of users, acne comes back after one year. For 25% of users, acne comes back after two years.
If your acne returns, you may want to try antibiotics or you could still try Accutane again.
How does accutane work over a long period of time?
Isotretinoin doesn’t always work. Sometimes it makes acne worse before it gets better. Sometimes, it makes acne much worse than it originally was and causes horrible scarring.
How is accutane prescribed?
Generally accutane is introduced at a very low dose and is steadily increased over many weeks. There actually are no specific guidelines as to how much should be prescribed to each person. However, research shows that a total dose of around 120mg per kilogram of an individual’s body weight is enough to banish acne for some time.
There are two schools of thought when it comes to tackling acne with accutane:
The high-dose: This is the method most used in the US where it is usually used for women. This means they would have to endure any potential side effects during the first few months.
The low-dose: This refers to consuming a lower than average dose each day, or less over a longer duration. This results in less side effects during the initial months with the exception of pregnancy.
(Source: Preston, Lydia. Breaking Out. New York: Fireside, 2004.)
Usually all other prescription acne medication is discontinued while on Accutane.
Take the medicine with food, you can take the entire daily dose with supper, this increases the absorption of the medicine.
How do I know if Accutane will work for me? How does accutane work for others?
There is no way to know if Accutane will work for you or if you will suffer from any of its side effects. However, you can gather your own opinion by reading some accutane journals. You may even think about keeping your own Accutane journal if you decide to use it and get a prescription from your doctor.