Use of Accutane
Accutane is a prescription oral medication used to treat severe acne. It is wonderfully effective but can also have potential side effects. Some side effects occur commonly, others are quite rare. It is important to be aware of what side effects can occur and steps that can be taken to minimize these problems.
The greatest concern with Accutane is it's potential to cause birth defects. Women absolutely positively must avoid any chance of pregnancy while on the drug and for one month after stopping the medicine. One month after stopping Accutane, the drug is completely eliminated from the system and there is no known long-term harm with regard to future pregnancy. Women on Accutane must have blood tests performed to establish absence of pregnancy.
Since Accutane works partially by reducing activity of oil glands, the most common side effect is extreme dry skin and chapped lips. This can be minimized by washing the face only with mild soap-free liquid cleansers (Cetaphil, Neutrogena, Basis) and then applying non-comdogenic facial moisturizers (Cetaphil, Neutrogena, Purpose). Avoid use of abrasive facial scrubs, toners, astringents or topical acne creams while on Accutane. In the shower, use mild bar soaps (Cetaphil, Dove) or moisturizing body washes, towel dry, and then be sure to apply thick moisturizer creams to the arms and legs (Cetaphil, Eucerin). Chapped lips are best managed with plain Vaseline petroleum jelly. The nasal passages also dry out, sometimes causing mild nosebleeds. This is also improved by applying petroleum jelly or saline nasal sprays inside the nose. If you wear contact lenses, these should be removed and carefully cleaned at bedtime. Use of artificial tears is helpful to decrease dryness of the eyes.
Accutane can lower the threshold for sunburn. You should minimize sun exposure and apply non-greasy (non-comedogenic) sunscreens with SPF 15-30 before outdoor activities. Mild headache or body aches sometimes occur, usually only during the first few weeks of treatment. These can be treated with Tylenol or Advil. Severe headache or visual disturbances rarely occur, but if present signal a serious problem that requires immediate evaluation and discontinuation of Accutane.
Accutane often causes mild elevation of triglycerides or fats in the blood. This is not a serious problem and returns to normal once the drug is discontinued. This is monitored by blood testing, so it is helpful to fast for 6 hours prior to blood tests to avoid falsely elevated triglyceride values. Liver tests are also checked but it is extremely rare to have any liver problems from Accutane. Other very rarely reported side effects include decreased night vision, hair loss and depression.
Accutane has very few drug interactions. One should avoid high dose vitamin A supplements since this worsens the usual side effects of Accutane. However, vitamin E (400 IU twice daily) can help reduce the dryness and chapped lips. Tetracycline antibiotics (including doxycycline and minocycline) should be avoided due to risk of severe headache when taken with Accutane. All other types of antibiotics are okay. Most people require a 5 month course of treatment to achieve remission of acne. Follow-up visits with blood tests are usually scheduled at 6-7 week intervals. After successfully completing a full course of therapy, most people will experience a remission that should last from a minimum of 6 months for up to 2 years, wherein little if any therapy is needed to keep the acne in check. Eventually the acne does relapse, but even then it is usually milder in severity than prior to taking Accutane. This milder relapsing acne can often be managed with more simple medications, though some people do require second courses of Accutane.
Accutane is a tremendously effective treatment for severe acne. With proper precautions and appropriate monitoring, you should be able to successfully complete a full course of therapy and finally experience relief from persistent acne.
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