DermBlog

Accutane for Acne

Craig Kraffert, MD

Over the past hundred years, an exceptionally large array of medications has been made available for patients with dermatologic diseases and disorders. Only a small subset of these medications is revolutionary and even fewer might be euphemistically considered ‘miracle drugs.’ The dermatology medications in this ‘miracle’ category include penicillin for syphilis, cortisone cream for rashes, Valtrex for herpes, Lamisil for nail fungus, Stelara for psoriasis, Botox for scowl lines and Accutane for acne.

What is Accutane?

Accutane is known generically as isotretinoin and is available under the Claravis brand. It is FDA approved for the treatment of severe cystic acne but is more widely used. The difference between Accutane and conventional acne treatment is that Accutane induces a predictable and typically durable remission from acne. All other acne treatments control acne signs and symptoms to some degree but do not arrest the process. This difference helps explain the value of Accutane in the treatment of acne.

Acne is a Medical Disease

Many folks tend to think of acne as a ‘cosmetic problem’ but this is false. Acne is a medical disease because it can cause physical and/or psychological scarring. Acne is often psycho-socially toxic and contributes greatly to the incidence of depression in its sufferers. As such, employing carefully considered acne therapy at the right time for the right patient is essential.

Accutane is frequently the best choice for dealing with acne situations. The reason is simple: With a typical five-month course of Accutane, acne usually goes away and stays away. It is when acne lingers that the risk of subsequent physical and psychological scarring increases greatly. Once acne is in remission, the risk of further physical or psycho-social scarring subsides.

Safety and Effectiveness of Accutane

Accutane is an ideal medication for acne sufferers in terms of its effectiveness. Also, contrary to a great body of misinformation on the Internet and elsewhere, Accutane is very safe. Because Accutane is a naturally occurring body chemical, it has an exceptional safety profile. Yes, there are predictable side effects. Yes, pregnancy must be avoided while on therapy. And, yes, very rarely patients discontinue treatment because of bothersome side effects.

As an open-minded dermatologist wishing to provide maximum benefit to patients, I have treated over five-thousand Accutane patients who did not experience severe side effects. Some critics have tried to link Accutane to an increased risk of inflammatory bowel disease but there is really no scientific proof based on all available data. Similarly, the FDA advises that Accutane may cause depression, but again there is no convincing evidence supporting the need for this advisory. Acne is closely linked to depression but Accutane patients have lower suicide rates and better mental health scores than age-matched people who are not Accutane patients. Read this post for more on the truth about acne and Accutane.

Accutane Side Effects

Accutane therapy is not fun as it predictably causes side effects such as dry lips and dry skin. It takes five months of treatment to see best results and often the results don’t really show up until near the end of treatment. Monthly visits are required as are two finger-stick blood tests. Still, for those with potentially scarring or chronic acne, Accutane is often the best choice overall. Accutane is truly one of dermatology’s ‘miracle drugs.’

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