Isotretinoin, which is frequently referred to as Accutane (the original brand name), is a vitamin A derivative that has been used as a short-term treatment for acne since the 1980s. According to Dr. Jorge Hinojosa of U.S. Dermatology Partners in Plano, Texas, “For people who have struggled with moderate to severe acne that is not improved by other treatments, Accutane can be highly effective and even cure acne in some cases.” In this blog, Dr. Hinojosa will walk through exactly what Accutane is and explain the top five things you should know when you start taking this medication.

What Is Accutane?
is the original brand name for an oral acne medication called isotretinoin. Today, there are numerous additional brand names, including Amnesteem®, Asorica®, Claravis®, Myorisan®, Sotret®, and Zenatane®. Even with the many new brand names, isotretinoin is still most often called Accutane. This skincare medication is derived from vitamin A, which is a naturally occurring nutrient within the body. Taking isotretinoin medications in the appropriate dosages can help to clear up even the most stubborn forms of cystic and nodular acne.

When Is Accutane Prescribed?
According to Dr. Hinojosa, “Isotretinoin is most often recommended for those who have chronic moderate to severe acne. The great thing about isotretinoin is that even those with treatment-resistant acne may see significant improvement after Accutane usage. When Accutane was first introduced for acne treatment, there were some negative side effects that gave this treatment a bit of a bad reputation. It’s important to follow the directions provided by your dermatologist who will closely monitor you for signs of potential side effects.”

Patients who are good candidates for isotretinoin include those who meet some combination of the following criteria:

• Have moderate to severe, chronic, or persistent acne breakouts
• Have large acne cysts, nodules, or other blemishes that are likely to cause scarring
• Have failed other acne treatments such as topical retinoids and oral antibiotics

While dermatologists have a significantly better understanding of how isotretinoin works and can use it safely with appropriate professional guidance throughout the process, Accutane may not be the right option for every patient, including:

• Women who are pregnant/nursing or plan to become pregnant during the treatment period
• Anyone under the age of 12
• Those who have allergies to isotretinoin or any of its ingredients
• Those who have an individual or family history of mental health conditions that may increase the risk for depression or suicidal ideation
• Those with a history of migraines
• Individuals with high levels of fat and cholesterol in the blood
• Patients who are taking contraindicated medications like tetracycline antibiotics, vitamin A supplements, and certain additional acne medications
• People with certain chronic and systemic illnesses, including diabetes, liver disease, kidney disease, Chron’s Disease, or ulcerative colitis may be able to utilize Accutane with additional monitoring

What Are the Side Effects of Accutane?
About the side effects of Accutane, Dr. Hinojosa says, “Isotretinoin became somewhat infamous for its adverse side effects. However, after decades of regular use, dermatologists have a much better understanding of the potential risks and the correct usage of Accutane, so we are able to prescribe these products while minimizing any potential negative effects with regular checkups and lab monitoring when needed.” Many of the potential side effects of Accutane use occur due to the type of vitamin it’s created from. Isotretinoin is derived from vitamin A, which is not a water-soluble vitamin. Excess amounts of water-soluble vitamins flush out of the system easily by drinking water. Vitamins that aren’t water-soluble will build up in tissue if higher doses are consumed, leading to numerous potential health risks. For this reason, it’s important to take the right dosage of isotretinoin. In the right amounts, Accutane is removed from the body within nine days and has no long-term side effects.

Most side effects that occur during Accutane usage are mild and will clear up after treatment is completed. Some of the common side effects of isotretinoin include:

• Dry skin and chapped lips
• Headaches
• Itchiness, rashes, hives, and general skin sensitivity
• Sensitivity to sun exposure may cause skin to burn more easily
• Nose bleeds caused by nasal passage dryness
• Body, joint, and muscle aches and pains
• Dry mouth and diminished saliva production
• Irritation of the eyes and surrounding areas
• Urinary tract or gastrointestinal symptoms
• Temporary hair thinning

What to Expect When You Start Taking Accutane
Before you start taking Accutane, your dermatologist will walk through your specific treatment plan step by step. While each person’s isotretinoin treatment will vary, some common things to expect when taking Accutane include:

1 – Accutane Should Only Be Used for a Short Time

When it comes to the benefits of isotretinoin treatment, Dr. Hinojosa says, “Accutane offers long-term results for improved skin health after just one course of treatment. Your weight determines how much vitamin A you can take in a day, and your dermatologist will use this to calculate the amount of isotretinoin you need to take. Most people take the full course of Accutane in four to six months.”

2  – You May Experience an Acne Breakout When You Begin Using Accutane

According to Dr. Hinojosa, “Most people who decide to use isotretinoin to address acne area are already experiencing severe acne breakouts, so hearing that their condition may worsen before it improves can be disheartening. While patients do often see a flare-up in acne breakouts when they first begin taking Accutane, these breakouts should clear up within the first few weeks of treatment, and patients will continue to see improvement throughout the time they’re taking isotretinoin.”

3 – Your Dermatologist will Take Some Additional Precautions
Because of the potential adverse effects of Accutane usage, most dermatologists will ask you to sign a consent form. This acknowledges that you understand all the potential risks and agree to follow the treatment plan as outlined by your dermatologists. Additionally, your dermatologist will perform a blood test before, during, and after taking isotretinoin to ensure you stay healthy throughout the process. For women who can become pregnant, monthly pregnancy testing is required.

4 – Adjust Some Lifestyle Habits
There are a few lifestyle habits you may need to change during Accutane treatment. Isotretinoin can cause severe birth defects, so it’s important to be proactive about avoiding pregnancy. For this reason, it’s essential that sexually active women use two forms of birth control throughout treatment. Additionally, Accutane can have an adverse effect on liver function, which can be exacerbated by alcohol consumption. For this reason, patients must avoid drinking alcohol while taking isotretinoin.

5 – Change Your Skincare Routine
One of the reasons Accutane improves acne is because it promotes faster skin cell turnover and diminished production of sebum oil. While this is beneficial to reduce the number and severity of acne breakouts, it can also cause skin dryness and irritation. For this reason, it’s important to use gentle, hydrating skincare products throughout isotretinoin treatment. Typically, an extremely streamlined skincare routine with a gentle facial cleanser followed by a cream-based moisturizer is adequate during isotretinoin treatment.

What To Expect When You Stop Taking Accutane
After completing Accutane treatment, you can expect the following:

• Your skin should continue to clear up and look better for several days or even weeks after completing the treatment
• Most side effects clear up within a few weeks
• Hair regrowth and general improvement in hair and nail health
• In most cases, one round of Accutane treatment is effective to prevent all but very mild acne breakouts
• Some patients may require two rounds of treatment to reach optimal results