The Sanova Guide to Accutane therapy | The Facts About Isotretinoin
Everyone seems to know that Accutane (a.k.a. isotretinoin) is an effective medication for treating moderate to severe acne. Accutane gets a lot of notoriety. “It’s the side effects that catches most peoples’ attention,” says Dr. Adam Mamelak, board certified dermatologist in Austin, Texas. “Reading different stories or claims on the internet is usually what turns patients off of this therapy. In actual fact, it’s an extremely effective medication.”
Here is information that may be extremely helpful for those who have decided to use Accutane to treat their severe acne.
Accutane is a systemic medication first developed for the treatment of rapidly dividing cells. It is a derivative of Vitamin A known as 13-cis-retinoic acid. It has been found to be an extremely effective and reliable treatment for severe and recalcitrant acne vulgaris. It has also been used to treat rosacea, folliculitis and a number of other skin conditions.
Accutane was the first trade name for the drug isotretinoin (generic name). Other brand names include: Absorica, Amnesteem, Claravis, Myorisan, Sotret and Zenatane.
How does Accutane work?
Accutane has been noted to have a number of effects on the skin that result in the reduction of acne formation. It shrinks oil glands in the skin that produce sebum. It also reduces the amount of P. acnes in oil glands. These bacteria live off the sebum and have been found to contribute to the development of pimples. Because it effects rapidly dividing cells, it changes the differentiation and decreases turnover of skin cells, leading to fewer cells that clog pores and hence, decreased acne formation. Accutane has also been found to have anti-inflammatory effects, decreasing red bumps and inflammatory acne lesions on the skin.
“The amount of medication required to be effective and have prolonged results is actually based on patient’s weight,” notes Dr. Miriam Hanson, a board certified Dermatologist in Austin, Texas. “The total amount of Accutane cannot be taken all at once – a patient would experience severe side effects. Therefore it is given in small amounts over time. We track the cumulative dose over the course of treatment, and stop treatment once a patient’s reaches their target.” Typically, patients are started at a lower dose, to ensure the medication is tolerated well. This dose is gradually increased over the treatment period. A dose of 0.5 mg/kg/day up t0 2 mg/kg/day can be used. In general, 40mg to 80 mg per day is prescribed, but low dose treatments are also used in specific situations.
How Long Do I Need to Be On Accutane?
The time required to reach the target dose, is the time required to be on Accutane. If a patient tolerates the medication well, and the dose can be titrated up quickly. The entire course of therapy tends to be about four to six months. If a lower dose of Accutane is used, therapy can be prolonged and last a longer period of time. The target range is typically 120 mg/kg to 150 mg/kg for individuals undergoing treatment.
When Will I See Results?
Most individuals start to see significant decreases in their breakouts and clearing of their complexion after the first month or two of treatment. While some individuals flare in their first month, many notice fewer breakouts even after a few weeks of treatment.
Is Accutane A Cure?
“In my experience, about 70 to 80 percent of patients that take Accutane don’t have problems with acne after treatment,” says Dr. Mamelak. “However, this does mean about 20 to 30 percent of patients do get breakouts.”
A large percentage of patients will find Isotretinoin is the answer to their acne problems, but there is a small chance that the acne can return. If you do breakout after Accutane, the acne is often less severe and readily controlled with a wash or cream. On occasion, patients might be prescribed an additional round of Accutane if the Dermatologist believes it would be effective.