Isotretinoin for acne

When is this medicine considered?

The medicine reduces sebaceous gland activity and acts on several processes involved in acne. It may be considered for severe acne, with risk of scarring or for an inadequate response to other treatments. The dose and the course depend on the disease severity, tolerability and response; there is no universal schedule. [1][2]

Dryness and laboratory monitoring

Common effects include dry lips, skin, eyes and nose; muscle or joint discomfort can also occur. Gentle care and moisturizing the skin and lips may help, but troublesome symptoms should be reported. The clinician may check liver function and blood lipids before and during treatment according to individual risk, more laboratory tests could be requested in special situation.

Inform your doctor if you have history of atopic dermatitis or family history of inflammatory bowel disease like Crohn’s disease. Your physician might discuss with your psychological impact of the drug as well in some cases. [1]

Pregnancy precautions are essential

Isotretinoin is contraindicated during pregnancy. It will cause birth defects. People who can become pregnant need take the necessary precautions, by using approved contraception methods at least one month before, during and one month after therapy. If pregnancy occurs or is suspected, stop the medicine and contact the prescriber immediately. It is not used while breastfeeding. [2][3]

If acne worsens or new symptoms appear

Some people might have a temporary acne flare at the start, thus, your physician will discuss this risk as appropriate. New mood changes, sexual symptoms or severe physical symptoms also warrant prompt medical contact rather than waiting for a routine appointment. [1][2]

Will one course be enough?

Improvement may last after one course, but acne can recur. The relapse rate is unpredictable. A clinician decides whether maintenance treatment or another course is appropriate. Report all medicines and supplements, especially vitamin A and antibiotics, before combining them with isotretinoin. [2]