Is Accutane an Accu-Pain?

For most teenagers, acne is a huge part of their lives. Most spend all of puberty looking for the miracle face washes, masks, or antibiotics that will keep the dirt and oil that cause it off their faces.

For some, these miracle products don’t work.

Isotretinoin, more commonly known by the brand name Accutane, helps combat acne that does not respond to these traditional treatments.

Created by Hoffmann-LaRoche Inc. and approved by the FDA in 1982, it was originally marketed as a chemotherapy drug, but found more success as an acne treatment.

Accutane is an oral retinoid, which means that it is a vitamin A derivative taken in the form of a pill. In addition to treating nonresponsive acne, Accutane also treats severe nodular or cystic-type acne, which is characterized by large, inflamed and painful breakouts. This type of acne affects deeper layers of the skin and often scars.

Senior Shannon Murphy says she starting having severe acne during fourth grade.

“I began to have big cysts on my face and shoulders,” she says. “I had to have cortisone shots on my face every couple weeks to try and get them to go away.”

She tried a dozen other methods in addition to the cortisone shots, but none of them worked. Brands like Proactiv even caused her acne to worsen.

“Thankfully, my doctor knew that Accutane was my only option and I had to go on it,” she says.

Junior Sydney Bohn had a similar experience. She too used many different topicals, such as Aczone and Tazorac, and other types of prescription pills, none of which solved the problem.

“Bad acne runs in my family,” she says. “I was tired of feeling uncomfortable all the time with the way I looked.”

Both girls ended up using the medication for around eight months, which is the normal time for a full course of treatment.

However, while the medication may help cure severe acne, there are some equally severe side effects.

“Somehow, we really don’t know the exact mechanism, it shuts down the oil glands and can induce a cure in some patients,” says local dermatologist Lauren Hirsch. “There are a slew of side effects that we have to monitor and be sure that we’re not harming you to treat the acne.”

The most common side effects include dry skin, eyes, and lips, nose bleeds, and eczema rashes in some cases. On higher doses, headaches, vision changes, joint pain and fatigue are common as well.

“The biggest side effect is just dryness,” says Hirsch. “Everyone gets dry.”

Both Murphy and Bohn experienced the more common side effects like dry skin, bloody noses and joint pain.

“My skin was incredibly dry,” says Murphy. “I always had to put extra conditioner in my hair because it got super dry. I had severe joint pain in my legs and in particular my knees.”

However, the side effects that really give Accutane such a bad rap are the birth defects and colon and bowel issues.

Accutane causes severe brain and spinal cord defects that make it impossible for a fetus to be carried to term. “If you are sexually active, we have to know. We’re not going to judge, we don’t care, but you can not have the baby if you do get pregnant,” says Hirsch.

Accutane is only available through a government program called iPLEDGE, which works to keep girls of childbearing age from getting pregnant by implementing the use of birth control during their treatment.

As for the colon and bowel issues, Accutane is believed to cause Crohn’s disease, Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD).

Absorica sales specialist Jeff Dickerson says, “There have been clinical studies to kind of establish an association between Isotretinoin and Crohn’s and IBD. In one study there was a conclusion that it did, but a later study said that it did not.”

Currently, the FDA states that there is no correlation between these diseases and Accutane.

“It’s been available in the United States since 1982 so it almost has a 35-year history of clinical studies behind it,” says Dickerson. “It’s one of the most studied molecules that dermatologists study.”

Despite all of the scary side effects and the 7,000 lawsuits filed against Hoffmann-LaRoche, Accutane is an effective medication, with almost perfect results.

Internal medicine doctor Thaichan Jobalia says that only 20% of patients will need another course of treatment. “Unfortunately, acne can be a chronic disease,” she says. “Many patients will need to continue some form of topical acne treatment after treatment.”

Both Murphy and Bohn say that they use topicals to treat whatever acne they get, which isn’t much. “I get very few blemishes now,” says Bohn. When they do get acne, however, it is never as bad as what they had before.

Looking back, Murphy says that she never felt self-conscious about her acne. “That might sound weird, but I didn’t mind it or care,” she says. “I love my clear skin, but I still feel confident within myself with any way I look.”

Bohn says that she felt happy and confident after her treatment. “It was like they gave me a new face. All my blemishes were gone and I was so incredibly joyful.”

Hirsch’s parting advice is to not be scared of Accutane. “It looks scary online and you can read a lot of things about it, but it’s a wonderful medicine,” she says. “I would be heartbroken if they ever took it off the market.”