- What Is Accutane (Isotretinoin)? Everything You Need to Know First
- Why Vitamin A Matters When Understanding Accutane
- How Accutane Dosage Is Calculated (and Why It Matters)
- How Accutane Works on Your Skin and Acne
- Accutane Side Effects: What You Might Experience
- Precautions and Warnings Before Taking Accutane
If you have acne-prone skin, chances are you’ve come across Accutane or its generic counterpart, Isotretinoin, during visits to your dermatologist. Accutane/Isotretinoin is a medication that sparks a lot of debates, yet, according to doctors, remains the most effective treatment for acne to date! Before delving into my personal experience with this medication, I want to provide you with all the necessary information about Accutane/Isotretinoin in this article. This data could be beneficial to someone, especially if you are considering taking the plunge!
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It’s crucial to ask all your questions to your doctor and pay attention to their advice before starting the treatment! Any doubt or potential side effect that might concern you should be openly discussed with your dermatologist. Trusting your doctor and feeling comfortable with them are crucial elements for the smooth progress of the treatment. Indeed, the treatment is lengthy and intensive, emphasizing the importance of fostering mutual trust.
This article serves a purely informative purpose and cannot replace your doctor’s advice. While I’ll strive to provide detailed information in this article, it’s always recommended to conduct your own research.
What Is Accutane (Isotretinoin)? Everything You Need to Know First
Formerly marketed under the name Accutane and now better known by its generic counterpart, Isotretinoin is a medication commonly prescribed for the treatment of severe and/or persistent acne. It also proves effective against psoriasis, rosacea.
Since 2002 in Europe and since 2009/2010 in America, Accutane is no longer available on the market, but its generic version, Isotretinoin, has taken its place. The withdrawal of Accutane is solely due to “commercial reasons,” related to patent expiration and generic competition, rather than health concerns.
Originally designed for cancer patients undergoing chemotherapy in the 1970s, Hoffman-La Roche synthesized the retinoid to reduce adverse effects. It wasn’t until 1982 that the drug was introduced to the market for the treatment of severe and/or persistent acne that had not responded to other treatments.
The active ingredient* is isotretinoin, a retinoid**. A retinoid is a derivative of vitamin A, naturally present in the body. Isotretinoin is highly teratogenic, meaning it can cause malformations in the embryo during its in utero development. It is strictly forbidden to become pregnant during the treatment and at least 1 month after its cessation!
*Active ingredient = a substance that is part of a medication’s composition and is responsible for its therapeutic properties.
**Retinoid = a class of chemical compounds derived from vitamin A.
Why Vitamin A Matters When Understanding Accutane
Vitamin A is a substance naturally present in the body and produced in small quantities by the liver. It exists in various forms in the organism: retinol, retinal (in the retina), and retinoic acid (in bones and mucous membranes) or retinyl palmitate (stored reserves in the liver).
The term ‘vitamin A’ encompasses all substances or their derivatives sharing a similar chemical structure and biological effects. In the international chemical nomenclature, these compounds are referred to as retinoids. Among these retinoids, retinol (primarily found in animal-derived foods, especially in the liver) stands out as the most active form directly assimilated by the body.
This fat-soluble vitamin naturally stores in the fat reserves of our body.
Vitamin A plays a crucial role in bone growth, visual health, reproduction, and immune system regulation. It also contributes to the health of the skin and mucous membranes (eyes, respiratory, urinary, intestinal), forming our primary defense barrier against bacteria and viruses.
What Are Provitamin A Derivatives and Do They Matter?
Carotenoids, or beta-carotenes, are the precursors of vitamin A, hence referred to as provitamin A. The body transforms (in the intestines) provitamin A into vitamin A. Carotenoids are derived from plants (carrot, tomato, sweet potato, pumpkin, spinach, squash, red pepper, melon, apricot, yellow peach, dandelion, lettuce, spinach, squash, mango, dark green leafy vegetables).
The daily vitamin A requirements for an adult are estimated as follows: 2,300 IU*** for women (except during pregnancy and lactation) and 3,000 IU for men, approximately 0.7 to 1 mg1.
***IU: International Unit, measures the quantity of a substance based on its biological activity.
It is rare to observe a vitamin A deficiency in developed countries, except in the presence of diseases hindering the absorption of this vitamin by the body, such as liver diseases, Crohn’s disease, and others.
It’s crucial to note that taking vitamin A supplements during Accutane/Isotretinoin treatment is not advisable!
Self-medication with vitamin A is strongly discouraged due to the risks of congenital malformations and the potential for osteoporosis. However, beta-carotene, which transforms into vitamin A according to the body’s needs, does not pose these drawbacks. A study published in 2010 confirmed that the conversion of beta-carotene into vitamin A decreases with an increase in dosage2.
How Accutane Dosage Is Calculated (and Why It Matters)
The dosage, defined as the amount and frequency of medication intake, is as follows:
- It generally ranges between 0.5 and 1.0 mg/kg/day.
To prevent relapses, the maximum dose to be reached is calculated by multiplying your weight by 120/150 mg.
Let’s use my example to illustrate this concretely: At the time of taking the medication, my weight was 58 kg. Thus, 58 kg x 120/150 mg = 6,960 or 8,700 mg was the dose to be reached to prevent any relapse in my case.
More detailed information about my dosage will be discussed in my upcoming article!
Note: Despite demonstrated effectiveness, relapses of around 20 to 40% have been observed. To avoid relapses, the maximum dose must be reached by the end of the treatment.
How Accutane Works on Your Skin and Acne
Isotretinoin acts selectively on the sebaceous glands by reducing their size. This has the effect of decreasing sebum production and, consequently, reducing the occurrence of pimples. Simultaneously, this medication influences bacterial development by limiting their proliferation, thereby contributing to the reduction of skin inflammation.
Accutane Side Effects: What You Might Experience
Isotretinoin is a medication that sparks intense controversy online, primarily due to potential side effects on mental health. Cases of depression, suicides, and anxiety have been reported, although studies conducted have not formally established a cause-and-effect link. However, it is crucial to discuss this matter with your doctor before considering starting this treatment and undergo careful monitoring throughout its duration. If you have a history of mental disorders, if these disorders are present in your family, or even if you have questions or concerns without apparent history, feel free to discuss them with your doctor!
Undesirable effects, such as dryness of mucous membranes, skin, hair, eyes, nosebleeds, as well as muscle and/or joint pain, are relatively common and can disrupt the patient’s daily life. The decision to undergo this treatment is not insignificant, and any prior research is beneficial to ensure proper execution of the treatment. It is crucial to establish a trusting relationship with your doctor, carefully follow their recommendations, and read the instructions attentively to be aware of potential side effects. It is also recommended to conduct your own research.
Personal advice: It is also essential to listen to yourself, pay attention to your body, and recognize signals indicating that something is not right!
For an exhaustive list of side effects, click here3!
Precautions and Warnings Before Taking Accutane
Isotretinoin is photosensitizing, meaning the skin reacts abnormally to the sun, potentially causing reactions such as sunburn and/or skin allergies. During Accutane/Isotretinoin treatment, it is crucial to avoid sun exposure and protect yourself by using sunscreen and wearing covering clothing such as a long-sleeved shirt, a hat, etc. The use of tanning beds and/or tanning lamps is also strictly prohibited.
Isotretinoin cannot be taken at the same time as tetracyclines (other acne medications)!
Cosmetic treatments, such as waxing, lasers, and dermabrasion, should be avoided. As the skin is weakened by the medication, these treatments can cause irreversible damage, such as scars, skin irritation, and hyperpigmentation, both during treatment and at least 6 months after completion.
!!Warning!! :
As mentioned earlier, it is imperative not to become pregnant or breastfeed while taking Accutane/Isotretinoin.
Source: Freepik
Additionally, if you are allergic to soy and peanuts, the use of this medication is contraindicated. Make sure to inform your doctor of all your allergies.
For a comprehensive list of contraindications, click here4!
In conclusion, Accutane/Isotretinoin stands out as the most effective treatment for severe acne for several decades. Despite its renown, it is not without controversy due to its side effects and the debates surrounding its implications for mental health. However, a thorough understanding of its mechanism, appropriate dosages, and essential contraindications allows one to approach this treatment with discernment.
The decision to undergo this treatment must be carefully considered, especially taking into account potential side effects, contraindications, and necessary precautions. Open communication with the dermatologist, careful reading of the instructions, and trust in one’s own bodily sensations are key elements to ensure the success and safety of the treatment.
After 20 years of battling acne, I made the decision to start this treatment 10 years after my dermatologist’s initial recommendation. Following extensive research on the internet, I hesitated to undergo this treatment for a decade, opting for natural solutions instead. However, when my acne reappeared more severely, I decided to take the plunge. Ultimately, whether this treatment is perceived as a “miracle” solution or a last resort, the journey towards beautiful and healthy skin requires a deep understanding, informed decision-making, open dialogue with a dermatologist, and most importantly, attentive listening to your own body.
If you’re curious about how my Accutane treatment went, I wrote a full article about my experience here. And for those wondering about the long-term effects, I also shared my post-treatment updates at 1 month, 3 months, and 1.5 years later, here!
Have you heard of Accutane/Isotretinoin? What were your reactions to the information found on the internet or in brochures? Feel free to share your experiences in the comments.
Thank you for reading, Beautifully Moi! See you soon!
Beautifully Moi 
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