What is Accutane?
Accutane (isotretinoin), or Roaccutane as it is known in parts of the world, was discovered in 1979 when it was first given to patients with severe acne, most of whom reacted with dramatic and permanent clearing of their acne symptoms. It is a vitamin A derivative (13-cis-retinoic acid) that is administered orally in pill form with a meal that contains an adequate amount of fat,1 normally for 15-20 weeks (3.5-4.5 months), although it is also sometimes prescribed at lower dosages for up to six months or longer. It was originally recommended for people with severe acne that did not respond to other treatments, but has gained in popularity in the past 25 years and is prescribed more and more frequently for less severe acne. This practice is controversial because Accutane is a serious medication that can cause severe birth defects as well as potentially long-lasting side effects to the user. Accutane need not be paired with other medications.How does Accutane work?
Exactly how Accutane works on a cellular level is unknown but we do know that it affects all four ways that acne develops.
- It dramatically reduces the size of the skin's oil glands (35%-58%) and even more dramatically reduces the amount of oil these glands produce (around 80%).
- Acne bacteria (P. acnes) live in skin oil. Since oil is dramatically reduced, so is the amount of acne bacteria in the skin.
- It slows down how fast the skin produces skin cells inside the pore, which helps pores from becoming clogged in the first place.
- It has anti-inflammatory properties.
Accutane side effects
Accutane is a systemic medication that affects the entire body. Side effects are numerous and widespread, and affect upwards of 80% of patients. Side effects are most often mild to moderate and reversible, but in some cases can be severe or long-term. When data exists, incidence information is listed.
More common
- Bone or joint pain
- burning, redness, itching, or other signs of eye inflammation
- difficulty moving
- nosebleeds
- scaling, redness, burning, pain, or other signs of inflammation of the lips
- skin infection or rash
Rare
- Abdominal or stomach pain (severe)
- attempts at suicide or thoughts of suicide (usually stops after medicine is stopped)
- back pain
- bleeding or inflammation of the gums
- blurred vision or other changes in vision
- changes in behavior
- decreased vision after sunset or before sunrise (sudden or may continue after medicine is stopped)
- diarrhea (severe)
- headache (severe or continuing)
- mental depression
- nausea and vomiting
- pain or tenderness of the eyes
- pain, tenderness, or stiffness in the muscles (longterm treatment)
- rectal bleeding
- yellow eyes or skin
- Incidence not known:
- Black, tarry stools
- bloating
- bloody cough
- bloody or cloudy urine
- bone pain, tenderness, or aching
- burning or stinging of the skin
- chest pain
- confusion
- constipation
- convulsions
- cough or hoarseness
- darkcolored urine
- decrease in height
- difficulty breathing
- difficulty speaking
- difficulty swallowing
- discharge from the eyes
- dizziness
- double vision
- ear pain
- excessive tearing
- fainting
- fast, irregular, pounding, or racing heartbeat or pulse
- fever with or without chills
- fractures and/or delayed healing
- heartburn
- high blood pressure
- hives
- inability to move the arms, legs, or facial muscles
- inability to speak
- indigestion
- inflamed tissue from infection
- irregular yellow patch or lump on the skin
- irritation
- joint pain, redness, stiffness, or swelling
- lack or slowing of normal growth in children
- loosening of the fingernails
- loss of appetite
- loss of bladder control
- loss or change in hearing
- muscle cramps, spasms, or weakness
- pain in the ribs, arms, or legs
- pain or burning in the throat
- pain or tenderness around the eyes and cheekbones
- painful cold sores or blisters on the lips, nose, eyes, or genitals
- painful or difficult urination
- pains in the chest, groin, or legs, especially calves of the legs
- pains in the stomach, side, or abdomen, possibly radiating to the back
- pale skin
- pinpoint red spots on the skin
- redness or soreness around the fingernails
- redness, soreness, or itching skin
- sensitivity of the eyes to sunlight
- shortness of breath
- skin rash
- sneezing
- sores, ulcers, or white spots on the lips or tongue or inside the mouth
- stuffy or runny nose
- sudden loss of consciousness
- sudden loss of coordination
- sudden onset of severe acne on chest and trunk
- sudden onset of slurred speech
- swelling of the eyelids, face, lips, hands, lower legs, or feet
- swollen, painful or tender lymph glands in the neck, armpit, or groin
- tightness in the chest
- unusual bleeding or bruising
- unusual weight gain or loss
- use of extreme physical or emotional force
- watery or bloody diarrhea
- wheezing
Some side effects of isotretinoin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them.
