Isotretinoin is an extremely powerful oral medication that wipes out acne for good in eighty percent of all cases. It acts as a fake vitamin A, which is highly effective in helping acne. But we all know there can sometimes be too much of a good thing—Isotretinoin is so powerful, it can cause some annoying side-effects. That’s what makes it a last-resort rather than something dermatologists give out to all acne sufferers willy-nilly.
Sidenote: You may have heard of Isotretinoin in it’s branded form, Accutane. While Accutane isn’t on the market anymore, there are a number of other generic brands that contain isotretrinoin, including Amnesteen, Claravis, Myorisan and Zenatane. There is also a new brand called Absorica that has better absorption than the generics.
Why would it be prescribed?
Isotretinoin should be considered the “big guns” of acne treatment. No need to turn to it unless absolutely necessary, but it’s good to know it’s there. In the event that you’ve tried everything that your dermatologist prescribed (maybe even a few times!), he/she might decide that it’s time to go iso, especially if your acne is taking a toll on your life, whether it’s widespread, causing severe scarring, or affecting you emotionally.
How do I take it?
Depending on your prescription, you’ll take Isotretinoin once or twice daily. It is important not only to take it with a meal, but to make sure the meal contains enough fat for the medication to be absorbed. That’s right. Save your no-dressing-kale-salad for another day (but when you do, add some avocado! It makes everything better! Everything!).
Sidenote: If, for nutritional reasons, you need to cut back on fat, the Absorica brand helps the medication get better absorbed with lower fat meals.
How long do I have to take it?
That depends. The higher the total dose you are prescribed, the longer it takes. Your dermatologist will determine the total dose you need based on bodyweight, but for explanation’s sake, let’s assume they decide that you need a dosage that is 50mg times your body weight and you weight 100 lbs. That’s a total dosage of 5,000mg.
Since a normal daily dosage is 40mg, we can assume you would be on the drug for approximately 125 days or a little over 4 months.
That’s one example, but depending on your urgency as well as how your body reacts to the side effects, a dermatologist may decide to speed up treatment or slow it down. It’s not unheard of for a patient to be prescribed a very low dose to take over the course of a few years.
How quickly does it begin to work?
This also really depends. Some people see results after the first month, some take longer. Oftentimes, back and chest acne will take at least a few months to see result.
What side effects can I expect?
The elephant in the room… those side effects we were talking about.
The first step to understanding these side effects is remembering that isotretinoin is synthetic vitamin A, and vitamin A has a function in nearly every organ in your body. So if you change up the amount of vitamin A in your body, you’re going to be fiddling with every one of your organs. But don’t stress! You may not get hit with all the side effects, and all of them are reversible, so the most important part is being aware of them ahead of time. That’s where we come in.
The Big List Of Isotretinoin Side Effects That You Shouldn’t Stress Over, But Should Be Aware Of:
1) Dryness. Everywhere. It’s the most annoying and, unfortunately, it’s the most prevalent. Dryness occurs in one hundred percent of people taking the medication. Isotretinoin turns off the sebaceous glands that responsible for surface grease production. And while surface grease may sound gross, it keeps your skin moist and protects it from that dry, cracked feeling. This is especially true for the lips, eyes and nose. Your lips will be Sahara-level dry, so keep the chap stick handy, and your eyes may be too dry to wear contacts (Brightside: you get to break out those massive Zooey Deschanel specs you’ve wanted an excuse to wear). Aaand your nose is gonna be so dry, it may cause nosebleeds. Yeah. We know. So annoying. But like we said, if your doctor prescribed isotretinoin then you probably really need it—so pack up on the kleenex, lotion, and eye drops and look forward to an acne-less future.
2) Muscle aches and pains. This occurs in maybe 15-20% of patients and is mostly a problem for elite athletes. If that’s the case, see if you can get treated during your off-season so you don’t deprive your team of that state championship you were planning to carry them to.
3) Abnormal liver or blood fat levels occurs in about 10-15% of patients. You won’t notice this yourself, but your dermatologist will do regular blood checks to make sure everything is a-okay. In the event that your levels are affected more than is normal, fixing it can be as easy as laying off fats and alcohol. If there’s any real trouble, stopping treatment makes any problems completely reversible.
4) Lots of other stuff that is rare to very rare. Your dermatologist will discuss all of this stuff in detail during your visit.
Sidenote: Many of the things you see online are blown out of proportion or just plain wrong. Don’t turn to WebMD for answers. Keep it old school and talk to actual humans instead. They’re much more reliable. And many of them have lollipops.