I was very surprised to learn a few months ago that Accutane had been taken off the market. As I wrote in the “about” section of this blog I suffered from terrible acne as a teenager; my acne was “cured” by a dose of Accutane. At the time I took Accutane I knew nothing of the potentially terrible side effects, and I was ecstatic with the results. Yes, I had some unpleasant side effects while I was using Accutane but only while I was using it. My face turned very, very red and became extremely dry and flaky. My lips were very dry as well. Those conditions were embarrassing but no more embarrassing than my acne, and once I finished taking the Accutane my skin was blemish free and no longer dry. Accutane is considered the last resort in acne treatments because it is so strong. But Accutane is also the only known “cure” for acne making it, in my opinion, irreplaceable.
Additionally, it is important to point out that there are great emotional and psychological side effects of acne, especially severe acne. Having acne takes a terrible toll on your self-esteem. Everyone wants to have blemish free skin, yet not everyone seems to be able to achieve it. I am not talking about getting a occassional pimple around your period but about acne that is wide spread, unattractive, and immediately apparent to everyone who looks at you. When you have acne in some ways it feels like the whole world has beautiful, clear skin but you. You become upset enough about how your skin looks that you begin to consider using just about any treatment, cream, dietary supplement, or lotion that is marketed at those suffering from acne. And then when nothing works you get more depressed about how you look. The great thing about Accutane is that it can both help you achieve blemish free skin and help you regain confidence and self-esteem.
What is Accutane?
Accutane (generic name isotretinoin) was first introduced in 1982 and is an oral drug derived from vitamin A. Essentially Accutane stops oil production in the sebaceous glands and then shrinks those glands. After this happens sebum cannot clog the hair follicle which sets off the chain of events that eventually lead to breakouts. Additionally, Accutane decreases cellular buildup in the follicles, kills the acne bacteria, and even controls inflammation. Once treatment is complete normal oil production returns and sebaceous glands slowly grow larger again, but they never return to be as large as they were originally. But what is remarkable is that after using Accutane most acne sufferers never experience the level of break-out that they did before taking the drug. As such it is the closest thing that can be considered a “cure” for acne. The Food and Drug Administration approves Accutane for the treatment of “severe recalcitrant nodular acne” – in other words acne that is characterized by many inflamed nodules and cysts that are found deep in the skin. Doctors today may also prescribe Accutane to patients who have acne scars or have a tendency to scar.
The most common side effect from taking Accutane is very dry and irritated skin. The single most common side effect is excessively dry lips – up to 95% of Accutane patients have this problem. Other side effects include mild nosebleeds, hair loss, aches and pains, rash, increased sun sensitivity, and headaches. And those are the temporary side effects. More severe, though less common side effects, include nausea, depression, severe stomach pain, increased cholesterol levels, and yellowing of the skin. Of course, the most disturbing problems associated with Accutane are very severe birth defects. The risk of birth defects are extremely high if the mother was taking, even a small amount of Accutane, during her pregnancy. Birth defects include heart, brain, and central nervous system defects, abnormally small or asymmetric heads, cleft palates, deformed eyes or ears including infants being born without ears. Accutane babies generally have severe developmental difficulties or can be born mentally retarded. Because of these severe birth defects doctors are cautious about prescribing Accutane to women of childbearing age. If the doctor does decide to prescribe the drug the woman must undergo pregnancy prevention counseling and have two negative pregnancy tests before being given the prescription. Prescriptions are only given on a month by month basis and are only reissued after a negative pregnancy test is obtained. There has been much talk about a link between Accutane and depression, but the number of suicides of Accutane users and those hospitalized for depression are very small when compared to the millions of people in the US who have used Accutane without a problem since its introduction in 1982.
Despite the harsh side effects and the very upsetting birth defects that can occur because of Accutane this drug has provided lasting relief and help to millions of acne sufferers. Though these side effects should not be dismissed lightly the benefits of Accutane must be highlighted. Accutane has proved to be the cure many people have sought for their severe breakouts.
Why was Accutane Taken Off the Market?
Accutane was manufactured by the drug company Hoffmann-La Roche Inc. Hoffman-La Roche Inc. said in a statement that they pulled Accutane from the market because of “business reasons“. Indeed Accutane, when it was pulled from the market, only made up 5% of the isotretinoin product sales. But perhaps more tellingly Hoffman-La Roche has and continues to fight lawsuits brought by patients who suffered some of the more extreme and terrible side effects of Accutane. The newest lawsuits against Hoffman-La Roche involve plaintiffs who developed Inflammatory Bowel Disease (IBD) after using Accutane. A simple google search to find out information about lawsuits involving Accutane turns up over 350,000 hits. There seem to be plenty of law firms out there who are willing to take on such a case.
So now that it seems pretty clear why Hoffman-La Roche Inc. pulled Accutane from the market what is someone to do who suffers from severe acne and who has tried lots of different treatments to no avail? Even though Accutane is no longer available generic versions of the drug are. Three such generics are currently available: Amnesteem™, Claravis™, and Sotret®.
Bottom Line: Judging by my own experience with Accutane would I recommend its use? Definitely, but only if you are under the direct and constant supervision of a doctor. Your doctor should educate you on the side effects and risks of taking a version of Accutane, but you should be sure to educate yourself as well.
Here are two great resources for more information about Accutane and about acne in general:
Breaking Out by Lydia Preston
For some new research about Accutane see my post: New Information About Accuntane