Rosacea is a common but not altogether understood skin disease that caused redness on the nose, cheeks, forehead and cheeks. Sometimes skin eruptions like acne occur on the red areas. The disease is not caused by alcohol abuse, as was previously believed, but drinking can make the symptoms worse.
“We talk a lot about avoiding triggers with Rosacea,” explains Dr. Miriam Hanson, dermatologist and skin care expert at Sanova Dermatology. “Avoiding excessive sun exposure, abstaining from alcohol, especially red wine, and staying away from spicy foods are some of the best ways to prevent flares.” But sometimes a patient’s best efforts can’t prevent redness and breakouts.
“It’s true there are a variety of therapies are available,” says Dr. Adam Mamelak, board-certified dermatologist in Austin, Texas, “everything from topical remedies to oral pills, even laser and light-based therapies are available. But even with an effective regimen, Rosacea can also at time be an extremely stubborn condition to treat.”
With breakthrough flushing, redness, bumps or enlarged oil glands, patients will sometimes ask is there anything else they can do? “This is often when Accutane comes up,” says Dr. Hanson.
Accutane, or its generic name isotretinoin, is a Vitamin A based oral medication that is most commonly used for severe and recalcitrant acne on the face and body. Low doses of Accutane have been used in severe cases of rosacea when other treatments have proven ineffective. It has proven effective in reducing the size and number of skin eruptions as well as reduce the skin changes, especially on the nose.
Accutane is not for everyone, and there are well documented side effects that Accutane can cause. Women who take the drug are required not to be pregnant nor become pregnant during the course of the medication because of the very real possibility of birth defects. “This, and very dry skin is really what we worry about,” explains Dr. Hanson. “As long as the patient understands that they cannot get pregnant while on treatment, and uses lots of moisturizers and emollients, the drug is usually very well tolerated.”
“The other side effects are much more uncommon,” says Dr. Mamelak. The medication can damage the liver, especially if patients drink alcohol during treatment, and elevated levels of blood lipids such as cholesterol have been documented. Other side effects can include muscle aches and joint pains, decreased vision at night time, headaches and sun sensitivity. Some reports have linked the drug to inflammatory bowel disease and depression, though there has not been any definite proof of this association. “Really, these are the reasons why we monitor patients so closely with follow up exams and blood tests while they are on treatment. If a patient can’t tolerate any of the side effects, they simply stop taking the drug and it is out of their system in less than 48 hours. Any and all side effects generally resolve shortly after that time.”
A person seeking a prescription of Accutane should consult with an experience dermatologist who can explain the benefits and risks of taking the drug.
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