Accutane (Isotretinoin) is a drug used in dermatological practice, which belongs to the group of retinoid drugs. The product has a systemic dermatotropic action and can be used either inside or topically. Isotretinoin has anti-inflammatory, antiseboric, sebostatic, keratomodulating and immunomodulating effects, which are manifested in systemic external application. In addition, the drug enhances the regenerative processes in the skin. The mechanism of pharmacological action of the drug is based on its ability to have a positive effect on the composition of sebum, reduce its production and facilitate the release from the sebaceous glands, as well as to eliminate the inflammatory process observed around the glands in acne. Before using the drug, it is recommended to learn more about the specifics of its mechanism of action. Check the most common questions and answers about Accutane (Isotretinoin) below.
Does Accutane Cause Depression?
Accutane is a drug that is considered one of the most effective drugs against acne. According to some doctors, it causes depression and suicidal tendencies. In 2010, eighteen-year-old Melissa Martin Hodges committed suicide in Manchester. She suffered acne and took Accutane. In 1997, during the reception of the analogue based on Isotretinoin, Simus Todd, the son of actor Richard Todd, committed suicide.
If these people seem to you just mentally unbalanced, then you have never suffered acne. Back in 1948, in his work Psychogenetic Factors of Psychological Disorders, Dr. Sulzblinger and Seidenz wrote: "There is probably no other such disease that causes more misunderstanding between children and parents, greater insecurity and feelings of inferiority, and a lot of mental suffering , like acne. "
Today, according to statistics, 90% of adolescents face pimple or acne of varying degrees of severity. And although the medicine has taken a long way forward, human nature has not changed: they all suffer the same way as 50, 100, and 200 years ago. Doctors associate acne phenomenon with a change in the ecological situation, chronic stress and the availability of drugs that people take without the doctor's consultation. About half of adult patients with acne suffer from depression.
The main active component of Accutane is isotretinoin, one of the forms of vitamin A. It is this substance that reduces the secretion of sebum, which provokes the appearance of acne. Isotretinoin was discovered in 1979, and three years later, in 1982, the drug Accutane, intended for the treatment of acne, was marketed. Twenty years, while the term of patent protection for the active substance (the same isotretinoin) lasted, the Accutane was the only acne drug of its kind. In 2002, this period expired, and other companies were able to offer their versions of this drug. Switzerland has produced Roaccutane, Belgium - anecnequant, India - Isotroin-20. The most popular in Europe today is Accutane and Roaccutane.
Suicides of young men and women who took it are widely discussed both in the press and on Internet forums. Most dermatologists consider Accutane and the remaining derivatives of isotretinoin to be the most effective drugs against severe acne stages. The effect of Accutane on the body has not been thoroughly studied. And the possible side effects, respectively, too. But the published facts are enough to understand: Accutane is not a harmless drug. Isotretinoin affects almost all systems of the body, including the gastrointestinal, musculoskeletal, nervous, genito-urinary.
Attempts to prove the connection between taking Accutane and suicide have been made since the beginning of the 2000s. But today, this relationship has not been proven. Similarly, its absence is not proved. Representatives of the Swiss company Roche, producing the analogue of Accutane, do not hide the fact that out of a half million people taking the drug, nine commit suicide every year. Sounds ominous. But roughly the same figures - nine out of a half million -is the statistics of suicides among healthy adolescents.
Teenagers part with life for a thousand reasons: unhappy love, conflicts with peers and even a low grade in the physics exam. If we talk about those who suffer from acne, then, according to British psychologists, the thought of suicide at least once comes to mind every fourth of them. In this case, all doctors say: the severe form of acne does not yet mean a severe form of depression. Conversely, with relatively light forms of acne, experiences can be much deeper.
Both dermatologists and psychologists explain this by the fact that adolescents with severe acne form are aware of their illness from the very beginning. They get used to it, accept it and gradually stop paying attention to it. But neither accuse nor justify Accutane on the basis of these data is impossible. We can argue that young people who were treated with the drug, and then decided to die, were in depression. We can say that Isotretinoin affects the nervous system and sometimes provokes a state of heightened anxiety. But not more.
How Long Do You Have to Wait to Get Pregnant After Taking Accutane?
Accutane, the most famous retinoic acid drug, is banned in many countries. Isotretinoin is one of the retinoids, i.e. drugs associated with vitamin A. Therefore, taking this drug (and other retinoids) during pregnancy can lead to very serious birth defects in the fetus or miscarriage. Women who are already pregnant or plan to become pregnant in the near future, who are engaged in unprotected sex or breast-feeding, categorically can not take retinoic acid.
Application of the drug to pregnant and lactating women: Accutane was released in 1982. Before it was approved, studies have shown that the drug causes birth defects in animals. Therefore, the manufacturer (Roche Pharmaceuticals, a division of Hoffmann-La Roche Inc.) warned against its use of pregnant women. Before you start taking the drug, a woman of childbearing age must necessarily discuss with the attending physician who has experience in the treatment of retinoic acid, is it suitable for this particular drug. In addition to birth defects in the fetus, retinoids can cause serious side effects in the woman herself. The most common side effect is a mental health disorder.
If the treatment does not work without isotretinoin, the woman should take the following precautions:
1. Before treatment: make a double pregnancy test and visit a gynecologist to make sure that there is no pregnancy. Read patient information containing a complete list of possible complications and side effects caused by this drug and give written consent for the treatment; use two highly effective methods of contraception, and start using them no later than a month before the planned start of treatment. You need to be protected during the course of treatment and at least 1-2 months after the end of treatment.
2. During treatment: every month to repeat pregnancy tests, in which case it could be interrupted at an early date; visit the doctor once a month for a new prescription; continue to use reliable contraception.
3. After treatment: make a pregnancy test after taking the last dose of the drug; at least for 1-2 months continue to be protected, in order to rule out the probability of pregnancy; make another pregnancy test one month after taking the last dose of the drug. If the pregnancy against the background of the drug still occurs, the woman, along with her doctor, will have to decide on the fate of the pregnancy. But WHO doctors recommend that these pregnancies be interrupted, because in 99% of the child is born with serious pathologies caused by the drug intake.
Women should not breastfeed while using retinoic acid and within 1 month after stopping the drug because it is not known that it can harm the baby. There is a very high risk of birth defects in a child if his mother takes retinoic acid during pregnancy even if she takes it in small amounts and for a short period of time.
The most frequent congenital defects on the background of taking retinoids are:
• hydrocephalus (cerebral edema (fluid filling space in the brain);
• microcephaly (small head and brain);
• mental retardation;
• anomalies of the organs of hearing and sight;
• wolf mouth, cleft lip and other anomalies of facial structure;
• heart diseases.
Retinoic acid can cause birth defects in the first weeks after conception, when a woman generally may not know that she is pregnant. Even children born without obvious birth defects may in the future have limited mental capacity or face great learning difficulties. The drug also increases the risk of premature birth and death of the child.
Vitamin A is crucial for normal fetal growth and development. However, an excess of retinol in the diet of the expectant mother can cause birth defects in her child. The recommended daily dose of retinol is 5000 IU. A study in America in 1995 showed that women who took more than 10,000 IU (international units) of vitamin A per day in the first 2 months of pregnancy doubled the risk of having a child with birth defects. Congenital defects were similar to those observed in infants exposed to isotretinoin.
The body produces its vitamin A or, if necessary, synthesizes it from a vitamin-precursor beta-carotene. Beta-carotene is found mainly in yellow and green vegetables and some multivitamin complexes. This form of the vitamin is considered completely safe during pregnancy.
However, the consumption by the expectant mother of certain foods in excessive amounts can lead to an overabundance of retinol in the body, which can cause birth defects in the child. Ready vitamin A is found in many vitamin supplements and certain foods, including liver (especially chicken), eggs, dairy products and breakfast cereals. A pregnant woman should be sure that her vitamins for pregnant women contain not more than 5000 IU of vitamin A, and she should not use any additional supplements containing this vitamin. Also, the future mother should limit the amount of liver that she eats, or completely eliminate it from the diet.
How Long is a Treatment of Accutane?
It is not recommended to take breaks in treatment with the drug for more than a day due to an increased risk of recurrence of the disease with a discontinuous course of treatment with this drug. If, for some reason, the daily dose of Acсutane cannot be prescribed in the recommended range, the duration of treatment should be proportionally increased to a set of the course dose of the drug.
The recommended daily dose is 0.4-0.8 mg / kg day. The recommended course dose of the drug Accutane is 100-120 mg / kg. Accutane is administered orally, preferably during meals, 1 or 2 times a day. In most patients, the manifestations of acne completely disappear after a single course of treatment. In case of relapse, it is possible to repeat the course of treatment in the same daily and the course dose. The repeated course is prescribed not earlier than 8 weeks after the first, as the improvement may be delayed.
Does Accutane Help Acne Scars?
Procedures for getting rid of scars and tripes after acne are of interest not only directly to those people who have encountered such a problem, but also cosmetologists, because their task is to help people get rid of the traces left behind by acne. As the scars and tripes are different and have different ways of appearance, each type of treatment must be selected by individual methods. Sometimes, successfully getting rid of one scar, by the same method of treatment we can negatively affect the other.
Keloid scars formed in conditions of reduced immunity, uneven, elastic consistency, their surface a little wrinkled, and above the skin they are quite significant. Often their growth does not stop and in appearance they become like warts. To get rid of such irregularities it is possible with the help of surgical intervention, but it is necessarily complex with other methods of treatment. After all, any surgical intervention can leave a new scar.
Before discussing the methods of treating scars after acne, let's ask ourselves a very important question. Can we prevent the appearance of such scars,? Yes, for the most part we can. If acne scars (after pustular acne) are found at the onset of inflammation, then it is sufficient to apply Accutane outwardly or to drink a course of antibiotics and contraceptives (for women). Also, application of bactericidal gels can stop the spread of infection and prevent the further development of inflammation.
How to Wash Your Face When You Take Accutane?
What should you be guided when choosing a skin tonic for skin prone to acne?
• Pay attention to the active ingredients in the product. Do you need a remedy to eliminate small skin defects? Then cosmetic products containing salicylic acid are the best choice. Glycolic acid is also a good alternative.
• Prefer tonic with low alcohol content, such preparations will not excessively dry the skin.
• It is extremely important to monitor how your skin reacts to the application of the tonic. Feel burning and tingling - immediately give up this remedy, it's too hard for you. Try to pick up something that leaves your skin fresh and clean, not damaged.
• If possible, consult a dermatologist about which makeup is best for your skin. Facial skin care is a real art, but you should not go to it for big sacrifices. Take care of yourself - use cosmetics correctly!
To cleanse the skin of the face is ideal water at room temperature or a little warmer. Many people are sure that hot water, like boiling water, opens the pores, while here the ice, on the contrary, closes them. In fact, this is not so, besides, such extremes can be harmful to the skin.
Too hot water contributes to couperose (the expansion or destruction of capillaries) and enhances inflammation. To close the pores cold water is not needed, because the pores are not doors, they do not open or close, and the water temperature does not matter. If you have enlarged pores, use cosmetic preparations containing alpha hydroxy acid. Such remedies remove the dead skin cells and dry the fat plugs, so that the pores appear smaller. Light chemical peeling, microdermabrasion (micro skin grinding) and retinoids also visually reduce the pore size.
Dry Lips And Skin When Taking Accutane
Worried about dry skin? Perhaps, it's all about the lack of certain vitamins. Skin is the largest organ that performs a variety of functions. Thanks to this body, we are reliably protected from external stimuli: viruses, bacteria, fungi, high and low temperatures and others. Due to the presence of sweat glands, the skin is able to give off excess heat energy with sweat, thereby maintaining the optimal body temperature.
In addition, the skin performs and exchange functions: fluid secretion, excretion and respiratory activity. In order for the skin to be able to cope with the functions assigned to it without problems, it needs vitamins and microelements. Some drugs can cause a number of side effects, which are mentioned in the instructions for use.
These drugs include a powerful remedy for skin diseases Accutane: this drug makes the skin tender and hypersensitive - the lips crack and dry during the entire treatment period. The same action has some other drugs for the treatment of acne. In people who take it, the most common side effects are: dry lips, mouth and eyes - in 96%, dryness in the nasal sinuses - in 51%, conjunctivitis - in 19% (all of these symptoms are classic in overdose of vitamin A ). Vitamin A is a fat-soluble vitamin that is deposited in adipose tissue. Excess of vitamin A can be toxic to the body, there are cracks on the lips, painful swelling, headaches, skin itching.