Sandhya Raghavan
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Written By: Sandhya Raghavan | Updated : October 27, 2017 5:56 PM IST
For many people, acne is just a passing phase, characterised by a few unsightly spots during teenage. Nothing you can t clear without a little help from benxoyl peroxide. However, for some acne may seem like a life-long ordeal, something that lingers even after their peers have grown out of it. Accutane or isotretinoin becomes a saviour for those with stubborn, cystic acne that profoundly affects the quality of their lives.
When it was first introduced in 1982, isotretionoin was prescribed only to those who suffered from severe acne that has not responded to any other kind of treatment. But things have changed. Today, dermatologists have been making a departure from traditional treatments such as antibiotics and topical creams, and increasingly recommending isotretinoin to treat even mild to moderate acne. It is the most efficient method of clearing acne with a success rate of 87 percent. Potent as it is, isotretinoin is not something that should be trifled with and must be used with utmost caution. Here are some of the important things you should keep in mind before you go on the drug.
One of the commonest side effects of using the drug is dry lips and dry skin. But don t panic. It is a sign that the drug is working and your body is absorbing it. At its worst, it can cause some inconvenience. You could use regular Vaseline or ask your dermatologist to recommend a good non-comedogenic moisturiser and a lip balm. Keep both at your desk when you go to work. You will need them.
Earlier, the relationship between isotretinoin treatment and psychiatric disorders was shrugged off as a myth. But it is clinically proven today the drug does worsen depression, anxiety and mood disorders. Accutane or isotretinoin has a history of causing mood swings and depression in people who already have a tendency for mood disorders, says Delhi-based dermatologist Dr Rajat Kandhari who runs Dr Kandhari s Skin and Dental Clinic. He adds that these symptoms are not seen in others. Read how acne can affect your emotional well being.
If you are on isotretinoin, getting yourself monitored is a must, says Dr Kandhari. You should routinely get tests to check your blood glucose and lipid levels. Liver function tests should also be performed to prevent any episodes of hepatotoxicity.
One of the reasons why isotretinoin is considered so controversial is because it can cause teratogenic effects or birth defects in the foetus if taken during or even a few days before pregnancy. The molecule closely resembles retinoic acid, a derivative of vitamin A which controls foetal development. Defects can range from hearing or visual impairment to facial dysmorphism and cognitive abnormalities. Usually, women who are to go on the drug are counselled about the drug s side effects and are asked to use contraception during sex. Patients are supposed to register on IPLEDGE, an FDA mandated website before they go on the drug, explains Dr Kandhari.
The doctor may sometimes not deem you fit to go on isotretinoin if you have certain underlying health problems. Some of the extreme side effects of the drug can exacerbate symptoms in people with such issues. People who have a tendency for depression and mood swings; patients with extremely dry or sensitive skins; and those with migraine are not considered ideal candidates for an isotretinoin treatment, warns Dr Kandhari.
Many people have fallen off the wagon a few weeks after the treatment if they don t see results. Isotretinoin takes three weeks to show some results but it almost always does. My advice is to keep the treatment going without discontinuing it. It is one of the reasons why I confidently prescribe it to my patients. Because, with the drug, I am sure I will be able to do justice to my patient s needs, says the dermatologist.
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