Nodular acne and cystic acne are some of the most painful forms of acne possible. Nodular acne appears as solid, domed lesions that occur very deep in the skin, surrounded by redness and inflammation. Cystic acne occurs when the sebaceous glands in the skin have a sticky lining that prevents easy cellular shedding. The dead cells block the glands which swell with oil secretion and eventually break into cysts. Both these types of acne can be extremely painful, and both pose the threat of scarring if left untreated. When severe acne has been treated with mild to moderate medication without a positive response, many dermatologists recommend Accutane.
Accutane (or Isotretinoin) is a derivative of vitamin A that is taken orally by acne patients, generally over a period of 16 to 25 weeks. The immediate effect of this drug is a quick and dramatic (though short-term) reduction in sebum production by the sebaceous glands. Without sebum creating pressure on the pore or gland, the nodules and cysts stop forming and the skin can start to heal. Accutane is also thought to decrease skin bacteria and help reduce inflammation in the skin follicles. Although acne may get worse before it starts to improve, the results generally start to show by the third month, and once the initial course of Accutane is finished, studies show that approximately 90% of patients have clear skin for at least a year. Should acne reappear after that time, patients claim that it is usually much more manageable. Some acne patients do end up taking a second course of Accutane, once given an appropriate recovery period from the first course, and this is also frequently very effective, sometimes able to stop nodular or cystic acne altogether.
The positive results that acne patients experience with Accutane can be, without question, tremendous. However, taking this drug to treat acne does not come without significant risk; there are many side-effects associated with Accutane. Milder side-effects include (but don't stop at) dry and cracked lips, dry eyes and skin, and increased sun sensitivity. More serious side-effects include slowed wound healing, nosebleeds, and even in some cases, depression. (These are only a few of the side-effects. To learn about the rest and the likelihood of experiencing them, consult a doctor or a dermatologist.)
Although these side-effects might sound like only a mild annoyance when compared to painful and embarrassing acne, Accutane is very hard on the skin and on the body organs. Dermatologists often suggest that non-emergency surgeries be put off until long after a course of Accutane in order to give the skin time to bounce back from its frail and delicate state. Cosmetic surgeries especially are to be avoided, as are procedures like waxing body hair which requires the skin to be robust. The liver has a particularly difficult time with Accutane, and can be seriously impaired along with the immune system. The most serious consequence of taking Accutane happens if a woman taking this drug becomes pregnant during the course of treatment. Accutane has debilitating effects on a developing fetus, causing severe birth defects and sometimes even fetal death.
Should you decide to approach your dermatologist to begin Accutane acne treatment, there is a process you must go through before you will even get considered for a prescription. Blood tests will be performed to determine pre-treatment liver and kidney function, as well as to monitor blood count and blood fats. Women will have an additional blood test to ensure that they are not pregnant at the time they plan to start taking Accutane, and it will be emphasized many, many times that they should not, under any circumstances, get pregnant during the treatment or for at least 30 days afterward. Female Accutane patients will have to commit to two forms of contraception, starting a month before the treatment, and extending an extra month at the end. And for both male and female patients, some dermatologists recommend psychological screening and then continuous monitoring by psychiatrists or therapists to ensure that depression doesn't become a problem.
If you're considering starting a course of this drug, do the research and become informed. There are several reasons that a dermatologist may recommend against Accutane, depending on your personal and family history. Above all, don't give up on looking for an acne medication that works well for you. There are more acne treatment options on the market now than ever before, so acne is never without hope.
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