Treat Severe, Nodular or Cystic Acne | Accutane (Isotretinoin) and Side Effects

Treatment for Severe Acne

People with severe cases of inflammatory acne should see a dermatologist. A dermatologist is best equipped to treat people with nodules or cysts. For patients with severe inflammatory acne that does not improve with traditional acne treatments, there are stronger medications. A doctor may prescribe isotretinoin (Accutane), a retinoid (vitamin A derivative). Isotretinoin is an oral drug that is usually taken once or twice a day with food for 15 to 20 weeks. It markedly reduces the size of the oil glands so that much less oil is produced. As a result, the growth of bacteria is decreased.

Isotretinoin is a very effective medicine that can help prevent scarring. Treatment lasts 15 to 20 weeks with isotretinoin. Acne will completely or almost completely goes away in most patients. In those patients where acne recurs after a course of isotretinoin, the doctor may institute another course of the same treatment or prescribe other medicines.

Side effects and precautions with Isotretinoin (Accutane)

Isotretinoin can cause birth defects in the developing fetus of a pregnant woman. It is important that women of childbearing age are not pregnant and do not get pregnant while taking Accutane. The National Institutes of Health say women must use two separate effective forms of birth control at the same time for one month before treatment begins, during the entire course of treatment, and for 1 full month after stopping the drug. You should ask your doctor when it is safe to get pregnant after you have stopped taking isotretinoin.

Some people with acne become depressed by the changes in the appearance of their skin. Changes in mood may be intensified during treatment or soon after completing a course of medicines like isotretinoin. There have been a number of reported suicides and suicide attempts in people taking isotretinoin; however, the connection between isotretinoin and suicide or depression is not known. If you or someone you know feels unusually sad or has other symptoms of depression, such as loss of appetite, loss of interest in once-loved activities or trouble concentrating, it's important to talk to your doctor.

There are other possible side effects of isotretinoin. A very common side effect is dry eyes, mouth, lips, nose or skin. Other side effects include:

• Itching
• Nosebleeds
• Muscle aches
• Sensitivity to the sun
• Poor night vision
• Changes in the blood, such as an increase in fats in the blood (triglycerides and cholesterol)
• Change in liver function

Your doctor may test your blood before you start treatment and periodically during treatment to be able to determine if isotretinoin should be stopped if side effects occur. Side effects usually go away after the medicine is stopped.

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Updated June 2011

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