Understanding Accutane Benefits and Best Practices for Use

Your skin is one of the first things people notice about you. For those struggling with cystic acne or severe acne, it can be challenging to feel confident and comfortable in your skin. While the majority of acne cases can be managed with over-the-counter products, approximately 20% require a more potent solution.

Fortunately, oral medications like Accutane (isotretinoin) provide a powerful solution for those seeking effective treatment. Accutane is known for its ability to normalize the sebaceous glands, ultimately clearing the skin and preventing acne in the long run.

This blog post will define what Accutane is, how it works, the unexpected benefits of Accutane for the skin, potential side effects, and risk factors associated with Accutane. We’ll also discuss best practices for taking Accutane successfully and safely.

What Is Accutane (Oral Isotretinoin)?

Accutane is a brand name for the pill form of the vitamin A-like medication isotretinoin. It is prescribed to treat severe, recurrent acne unresponsive to other treatments.

Black Box Warning

The FDA has issued a black box warning for Accutane due to its potential for serious side effects and risks, such as severe birth defects, premature births, miscarriage, and death in babies if taken during pregnancy. If you are pregnant or may become pregnant, it is important to talk with your doctor about the risks of taking this medication.

Additionally, those taking Accutane must follow strict safety protocols outlined by the FDA’s iPLEDGE program. These protocols require that patients have a negative pregnancy test and agree to use two forms of birth control before taking the medication.

How Does Accutane Work?

Classified as a retinoid (or a derivative of vitamin A), Isotretinoin limits the amount of oil your body produces. It alters DNA transcription in the sebaceous glands, forcing them to shrink and making sloughed-off cells less sticky. That, in turn, helps to reduce the amount of bacteria on your skin that can cause breakouts.

It also helps to reduce inflammation and redness associated with severe forms of acne. By doing this, Accutane can prevent future breakouts before they even start. As a result, it’s a more effective treatment for those who have tried other treatments but have not seen any improvement in their skin.

Top 5 Accutane Benefits

Accutane is a powerful medication that can help those with severe acne enjoy clearer, smoother skin. It can potentially reduce oil production, treat severe acne, produce fast results, minimize scarring, and improve self-esteem. Here are five of the top benefits of taking Accutane:

1. Reducing Oil Production

Oily skin is a common dermatologic concern prevalent among all types of patients, including those without acne. It is closely associated with larger facial pores and an “unclean” or “greasy” appearance. Unfortunately, various factors have been linked to the pathogenesis of excessive sebum production in the skin, making it extremely difficult to control.

According to PubMed research, vitamin A (retinol) derivatives, such as isotretinoin – the active ingredient in Accutane – have been found to interact with specific nucleic acid receptors on the skin.

The interaction binds to retinoic acid response elements (RARE) in deoxyribonucleic acid (DNA) and regulates the production of proteins necessary for the repair of photodamaged skin, growth and differentiation of keratinocytes, anti-inflammatory actions, and the suppression of sebum production.

During oral isotretinoin therapy, sebum production decreases by 90% – a substantial improvement that has offered much-needed optimism among patients with severe acne.

2. Treating Severe Acne

Severe acne has an advanced effect on the skin, as it can produce deep and painful cysts and large nodules. This type of acne can result in scarring and is often resistant to treatment with topical creams or antibiotics.

Accutane (Isotretinoin) has been found to be highly effective in treating severely inflamed lesions. Accutane’s phenomenal efficacy may be due to its ability to influence cell-cycle progression, cellular differentiation, and apoptosis.

Studies have also suggested that Accutane has anti-inflammatory properties and helps reduce the number of surface and ductal P. acnes on the skin.

3. Long-Term Clear Skin

Permanent scarring, blackheads, and discoloration are all common issues that people have to contend with when it comes to severe acne. However, many patients enjoy long-term or even permanent clear skin after completing a course of Accutane treatment.

The medication can help clear up existing acne and prevent new lesions from forming. Good skincare habits can help maintain the effects.

4. Minimizing Scarring

By treating active acne, Accutane reduces the risk of scarring from severe blemishes as they heal and fade away faster with fewer marks left behind on the skin’s surface.

In some cases, patients have reported that their scars have improved or completely vanished after taking Accutane treatment. However, it is essential to note that this result will depend on the severity and type of scarring a patient has before treatment.

5. Improving Self-Esteem

About 80% of teenagers suffer from acne, a condition that can lead to depression, social anxiety, and low self-esteem. The positive effects of clearer skin on mental health cannot be overstated.

With clearer skin comes an improved sense of self-confidence and self-esteem, often one of the most rewarding Accutane benefits for many patients.

What Are Common Side Effects of Accutane?

Since Accutane is an oral medication, the side effects are witnessed in many areas of the body. While potential side effects vary from person to person, they can be mild or severe. 

Mild Side Effects

Mild Accutane side effects are manageable and include the following:

• Lips chapping: 90% of people experience dryness around the mouth and lips. You can prevent this by using a lip moisturizer like Aquaphor or Vaseline.
• Dry skin and peeling: 80% of people experience dry skin, which can cause peeling. Using a moisturizer multiple times throughout the day and avoiding skincare products with harsh chemicals like retinol or AHAs is recommended.
• Dry nose and nosebleed: 80% of people experience this side effect. An AYR Saline Nasal Gel can be used to help keep the nose moist and prevent bleeding.
• Irritation of the eyes and eyelids: about 40% of people experience dry, itchy eyes. You can help soothe this by using artificial tears or eye drops.
• Joint and muscle pain: About 10% of people experience joint and muscle pain. If the discomfort becomes severe, speak with your doctor to determine what kind of treatment you need for relief.
• Hair thinning and loss: This is seen in about 5% of people. It is important to use gentle hair care products and take vitamins like biotin or fish oil to help prevent breakage.

Severe Side Effects

Some severe side effects of Accutane include:

• Sexual side effects such as erectile dysfunction
• Hepatotoxicity (liver damage)
• Inflammatory bowel disease
• Anaphylaxis (severe allergic reactions)
• Severe headaches, chest pain, and vision changes.
• Agranulocytosis (low white blood cell count)
• Potential birth defects like central nervous system malformations, skull malformations, and parathyroid hormone deficiency.
• Decreased night vision
• Elevated triglycerides and cholesterol

However, these are either preventable, rare or manageable.

Mental health issues like depression have been implicated as potential complications of oral isotretinoin treatment, but large-scale studies do not show they have a clear link. On the other hand, acne is known to cause emotional stress in many patients.

Speaking with your doctor about potential risks before taking this medication is important.

What Should You Be Aware of Before Taking Accutane?

There are many Accutane benefits, but it also has the potential for serious side effects. Understand the risks and ensure that you are a suitable candidate before taking Accutane medication.

Before taking Accutane, a doctor will likely perform a physical exam, review your medical history, and conduct a pregnancy test. It is essential to be honest with your doctor and disclose any medications or supplements you may take, as they can interact negatively with Accutane.

To ensure a safe medication experience, tell your doctor if you have any of the following conditions:

• Mental health issues
• Heart disease or high cholesterol
• An eating disorder such as anorexia
• Intestinal issues such as inflammatory bowel disease or ulcerative colitis
• Diabetes
• Asthma
• Osteoporosis or low bone mineral density
• Liver disease

It is important to remember that this medication should not be taken by anyone younger than 12 years old, and women who are pregnant or breastfeeding should avoid taking Accutane.

Best Practices for Taking Accutane Successfully and Safely

Your dermatologist can help you determine the best skin treatment plan. However, taking the appropriate steps can help you ensure that your treatment is successful and safe. 

Be sure to follow your skin specialist’s instructions and adhere to the following best practices when taking Accutane:

Take the Medication Exactly as Prescribed

The first close step to successful treatment and enjoying Accutane benefits is ensuring that you take the medicine as directed. If you missed a dose, do not double up to make up for it. Instead, skip it and resume taking the medication as directed. While the recommended dosage ranges between 0.5 to 1mg/kg/day, given in two doses, proper adjustments may have to be made depending on the patient’s response or side effects.

Do Not Share the Medication with Others

While Accutane is a powerful medication, administering it should be under the close supervision of a dermatologist. Even if you’re excited about sharing Accutane benefits with family or friends, do not share this medication with others! It can cause severe harm or death.

Use Reliable Birth Control Methods To Prevent Pregnancy

Females who are pregnant or may become pregnant must use two forms of efficient birth control while taking this medication. Although male patients have a lower risk of causing congenital disabilities when taking the drug, telling your doctor about any plans to become pregnant is still essential.

Inform the Prescribing Doctor of Any Other Medications or Supplements Being Taken

Your doctor will need to know about any other medicines or natural supplements you may be taking. Taking Accutane with certain antibiotics, seizure medications, vitamin A drugs, and blood thinners can increase the risk of side effects and even cause harmful interactions.

Get Regular Blood Tests to Monitor Liver Function and Cholesterol Levels

Regular blood tests are necessary to monitor Accutane, as it can cause temporary hepatic enzyme elevations and cholesterol levels to increase. Your doctor must keep track of these changes to adjust your dosage accordingly so you can fully enjoy Accutane benefits.

Report Any Side Effects Immediately to the Prescribing Doctor

Common side effects include dry lips, nosebleeds, redness of skin or eyes, joint pain, and headaches. If you experience any side effects that are bothersome or severe, do not hesitate to report them to your doctor right away.

Avoid Excessive Sun Exposure and Use Sunscreen Daily

Accutane can make you more sensitive to sunlight. To appreciate full Accutane benefits, it’s essential to stay out of the sun as much as possible or use appropriate sunscreen with SPF 30 and above.

Conclusion

While there are many Accutane benefits for acne, it is crucial to understand that taking this medication should only be taken under the close supervision of a dermatologist. Following best practices and taking medicine as prescribed can help maximize treatment results without increasing your risk of side effects or interactions. In addition, following a good skincare routine on top of taking Accutane can help you maintain your results for years to come.

If you are considering taking Accutane for acne, talk to a board-certified dermatologist first. Our team of dedicated skin care experts at BHSkin Dermatology is here to help you realize full Accutane benefits and reach your goals of healthier, clearer skin. To learn more or book an appointment today, visit our website.

Author: Don Mehrabi

Don Mehrabi, MD, FAAD, is LA’s leading board-certified dermatologist who treats patients, builds the BHSkin clinics, and raises three kids. This blog builds on medical studies combined with Dr. Mehrabi's first-hand experiences from practicing in Encino-Tarzana, Glendale, and online