Accutane (isotretinoin)

Isotretinoin is an anti-acne medication that is chemically related to retinoic acid and retinol (vitamin A). Although its exact mode of action is unknown, this agent works by inhibiting sebaceous gland functioning, which diminishes oil production in the skin and hinders acne development. This product is sold in many countries throughout the world, and is largely recognized as one of the most effective medications available for treating severe acne. Studies also suggest that it has one of the highest success rates with even the strongest cases of clinical acne. Given that acne is one of the most common side effects of anabolic/androgenic steroid use, isotretinoin is utilized by bodybuilders and athletes to reduce or eliminate this cosmetic issue  during steroid therapy. Isotretinoin was developed by the pharmaceutical company Hoffmann-La Roche, and was first introduced as a drug medication in 1982. The company marketed it under the brand name of Accutane, and retained the patent rights until 2002. Now that the patent has expired, there are a number of generic versions of the drug available. Isotretinoin is not a controlled substance, but has been regulated by the FDA in recent years due to potential side effects. Due to this, there are some very strict guidelines in place for prescribing the drug. Isotretinoin is most  commonly supplied in soft gel like capsules of 10, 20, and 40mg.

Acne occurs due to an excessive production of sebum from over-active sebaceous glands in the skin. The sebum blocks the sebaceous glands, which prevents the oil from flowing freely out and causes an accumulation of sebum under the skin. The bacteria associated with acne thrive in these conditions. They feed on the sebum, and produce waste products and fatty acids that irritate the sebaceous glands, making them inflamed and causing spots. Isotretinoin decreases the size and activity of the sebaceous glands in the skin, which reduces the amount of sebum that is produced. This stops the glands becoming blocked, and means bacteria are less likely to thrive. It also reduces the inflammation in the skin. Isotretinoin can have serious side effects and its use must be supervised by a dermatologist. It is reserved for the treatment of severe acne that has not improved with a course of oral antibiotics, and for acne with cyst formation. The user’s acne may worsen at the start of treatment, but this usually subsides within 7 to 10 days of continued treatment. In most cases, complete or near-complete clearing of acne is achieved with a 12 to 16 week course of treatment, and you are likely to remain free of acne for a long time. Repeat courses are not normally recommended, unless a definite relapse is seen after treatment is stopped. Isotretinoin is a powerful medication with many potential side effects. The drug has stirred up quite a controversy due to the fact that it has been linked to birth defects. Any woman who might potentially be or become pregnant should not go near this drug due to this. The drug has also been linked to depression and suicide due to the effects that it has on certain parts of the brain that affect depression and well being.

Accutane comes as a capsule to take by mouth. Accutane usually is taken twice a day. Users are urged to take Accutane with food or milk because it is believed to increase the absorption rate. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take Accutane exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. You may not notice any improvement in your condition until after 4-6 weeks of treatment, and your acne may actually get worse during the first few weeks. Your acne should improve within 15-20 weeks. If it does not improve, your doctor will probably stop giving you Accutane for 8 weeks and then restart your treatment.