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Accutane

Accutane is the brand name of a drug manufactured by Roche. The generic name for Accutane is isotretinoin. Chemically it is related to retinoic acid and retinol (vitamin A). Some people think of Accutane as if it were the oral form of Retin-A, but this is not correct. The effects and side effects of the two products are very different.

First the good news. Accutane, used properly, is very effective for treating severe cystic acne. Severe cystic acne is not just a nuisance. It is an awful disease that can cause permanent scarring. The scarring can lead to permanent disfiguration and tremendous loss of self esteem. It takes about 20 weeks of Accutane treatment to get the desired result. Many times, the results are spectacular with long term reduction in cystic acne. Some patients even seem to be cured.

The problem with Accutane is that it can cause terrible side effects. Moderate to severe dryness is an expected and manageable side effect. Usually the dosage can be adjusted to balance the side effects with the need to achieve the desired results.

There are other side effects that can be much worse. These side effects include:

Most (but not all) of the side effects of Accutane, even the severe side effects will stop and reverse when the drug is discontinued. The biggest problem is the potential for birth defects. This problem is so severe that a mandatory program, called iPLEDGE has become a legal requirement for anybody in the USA who wants to dispense or use Accutane. The program requires extremely close monitoring of patients to make sure that nobody who uses Accutane is pregnant when they start or becomes pregnant during the treatment. The program is very time consuming for the doctors and their staff. Many doctors have chosen to not use Accutane at all. In my opinion, Accutane should be used only by doctors who understand and appreciate the issues with this very powerful drug.