What is Accutane, How Is It Taken, and More

What is Accutane (isotretinoin)?

Vitamin A-derived pill
The "gold standard" for severe and unresponsive acne
Works reliably for the vast majority of acne, even the most serious nodular-cystic scarring forms
The only medication that usually achieves long-term control or a permanent cure of acne
Shrinks oily sebum-producing glands
Prevents clogging of pores

How is Accutane taken?

Ideal is to take 1 pill twice a day with a large meal (breakfast and dinner) to help your body absorb it
Once-a-day dosing can be used if you skip a meal
Absorica is a brand that is well-absorbed even without a meal
Absorica LD allows a lower dose to achieve the same results
There are excellent branded generics, if Absorica is not covered by your insurance
Typical course to achieve clearing is about 6 months, and an additional 2 months increases likelihood of permanent cure

Is Accutane for acne safe?

Accutane was approved by the FDA in 1982
Has never been pulled for safety reasons in the US or any other country
The original Accutane brand made by Roche was discontinued in 2009 due to competition from generics, not safety issues
Several high-profile lawsuits have increased the public's anxiety about Accutane, but extensive scientific studies show that it is safe for the vast majority
It can cause birth defects if taken during pregnancy, but has no effect 1 month after ending course, and does NOT affect future fertility
All patients must be registered in an FDA-mandated program, called iPledge, requiring monthly visits and pregnancy tests in women
Scientific studies show that Accutane does NOT cause depression or inflammatory bowel disease but may rarely trigger flares in people who have a propensity to these conditions

What are potential side-effects of Accutane?

Accutane dries out the oily sebum secretions of the skin, and usually causes tolerable dryness of the lips, and occasionally nose and eyes
This is the effect we most commonly see and it is not a true side-effect, as this is how Accutane works
Uncommon side-effects include: initial flare; severe dryness leading to nosebleeds; headaches or dizziness; stomach or bowel symptoms; changes in vision; changes in moods; joint aches or muscle pain; temporary hair thinning; sun sensitivity; abnormal blood tests (triglycerides and liver function tests)
Potential side-effects can be reduced by optimally dosing at a smaller dose initially and increasing dose gradually over the first 2-3 months, while monitoring for side-effects
If a side-effect does develop, it can be controlled, and will resolve
In our extensive experience of using Accutane, very few people have stopped it due to side-effects, and the vast majority are very happy they took it

Important Facts about Accutane

Accutane does NOT make existing scars or dark spots (post-inflammatory hyperpigmentation) or red blemishes (post-inflammatory erythema) disappear
These usually fade slowly over 6-12 months after Accutane clears your skin
Cosmetic treatments can be used if these don't disappear with time
Accutane does treat existing active acne and prevents new scars and blemishes
Although most people begin to see improvement after 1-2 months of treatment, the full response may take 6 months
Accutane is usually covered by medical insurance
If it is not covered, or if you do not have insurance for prescriptions, we work with specialty pharmacies that can deliver a typical 30-day course for about $60 -120, depending on the dose you need
We try to balance blood testing with the requirements for safety
Blood testing can be performed by any lab, and should be done fasting for 8 hours (most people do it in the morning before breakfast)
Required monthly visits during an Accutane course can be done with convenient eVisits or Telehealth, so you don't have to miss school or work
Severe acne can cause lifelong physical scars and emotional distress, which needs to be considered in individualized treatment options

Is Accutane A Good Option For You? Ultimately, it depends on:

Dr. Shraga has extensive experience in using Accutane to maximize clearing acne and to minimize potential side-effects.

IS ACCUTANE RIGHT FOR YOU?