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Accutane and Its Effects on the Body |
Accutane Before & After [What To Do During Accutane Recovery].
Viewed by some as a "miracle therapy," isotretinoin is a widely used medication for patients with refractory moderate to severe acne vulgaris. The drug has been the subject of public scrutiny for some time concerning potential side effects, including depression and birth defects.
While the iPledge program effectively addresses many of these concerns, some patients and many parents still express concerns about the drug's safety. When considering isotretinoin therapy, it is important for physicians to explain to patients and parents that with proper monitoring and compliance, isotretinoin is a safe, effective treatment.
Solid patient education is the foundation of therapy. Included in this education should be an overview of potential side effects associated with isotretinoin therapy.
This article will review these side effects and offer simple measures that patients can take to help prevent or manage them. Before beginning isotretinoin therapy, women of childbearing age must be absolutely certain they are not pregnant and do not become pregnant while on the drug or in the one month following completion of treatment.
It is imperative that patients know that isotretinoin likely will cause severe birth defects in a child conceived during therapy or in the month following therapy. Large follow-up studies have shown that after one month of completion of therapy, there is no increased risk of birth defects compared to women who have never taken the drug.
Although iPledge registration may be viewed as a laborious process, it should serve to reinforce and augment your efforts in guiding patients through a successful course of isotretinoin therapy. This includes fully informing them about the risk to the fetus if the patient were to become pregnant and the need for regular laboratory pregnancy testing.
Per the iPledge program, sexually active women of child-bearing age must use two approved forms of contraception, one primary and one secondary, for the one month before, during, and for one month following therapy. Women may instead choose complete abstinence for this time frame. Some physicians insist all female patients of child bearing potential take an oral contraceptive during this time, even if not sexually active. Importantly, all patients, men and women, must be aware of the pregnancy issue, as iPledge requires all users of the drug to be reminded during each office visit not to share the drug with anyone and not to donate blood during treatment or in the month following treatment.
Most patients report that they sunburn more easily during isotretinoin treatment. Physicians should caution patients not to sunbathe or use artificial tanning parlors—a good message for all patients.
Use of a sun umbrella while at the pool or beach and avoidance of excessive sun exposure during peak sun hours of 10am to 3pm are advisable. Sunburn treatment may include use of cool tap water compresses for 10 minutes a few times a day and aspirin or if allergic to aspirin, choose acetaminophen in manufacturer-recommended doses.
If the sunburn blisters, patients should seek medical care. Biafine Topical Emulsion OrthoDermatologics may help soothe and heal a sunburn. Most individuals develop mild nuisance chapping of the lips while on isotretinoin. This is one of the most common effects of the drug. Occasionally the lips become more inflamed, prompting patients to seek aid.
To prevent chapping, suggest 10 or more applications daily of a lip balm with sun protection such as ChapStick Ultra 30 or Blistex Ultra Protection. If chapping persists, consider Vaseline or Aquaphor Healing Ointment. Another option is for the patient to hold a warm, moist washcloth between the lips for five minutes several times a day, followed by applications of the lip balm.
It is important not to use the corticosteroid ointments for more than a few days at a time due to potential side effects from their overuse. Dry skin and asteototic eczematous dermatitis also are fairly common during isotretinoin treatment, especially on the face, arms and hands. Rarely, impetiginization, peeling of the palms and soles, or paronychia may develop.
Patients with a tendency to overbathe should be reminded that this behavior is counterproductive. I suggest that patients not take more than one comfortably warm not hot bath or shower per day unless absolutely necessary. Most people require soap only to the axillae, underwear areas, and feet, in addition to a normal amount of hand washing and shampooing.
Additional measures to combat dryness include a humidifier for the bedroom during cold weather, and keeping the bedroom window open a crack at night. Since topical acne medications may add to dryness, discontinuing all other acne medications while on isotretinoin is advisable. OTC antibiotic ointments generally are not effective in treating bacterial infection. Patients may occasionally experience nosebleeds due to dryness of the nasal mucous membranes with consequent blood vessel fragility.
Patients should be reminded that applying pressure or packing the nose will help stop the nosebleed. If the bleeding is not readily stopped, medical attention should be sought. Acne Flaring.
While mild worsening of acne occurs occasionally while on isotretinoin, severe flaring acne fulminans also is possible, albeit rare. Explain to patients that usually it will take up to two months before they start to see improvement with isotretinoin therapy.
To avert worsening, it is helpful to start patients on a low dose 0. Importantly, communication with patients on this matter is essential. Occasionally, a limited tapering systemic corticosteroid course may be necessary to control a severe flare. Eye dryness typically is mild, but can occur. Occasionally the dryness causes slightly blurry vision or irritation of the eyes. In these instances, contact lenses, especially hard lenses, may be more difficult to wear.
For patients experiencing eye dryness or irritation, artificial tears, such as Celluvisc or HypoTears, may help. Ophthalmic consultation may be warranted if symptoms do not abate. Musculoskeletal Symptoms. Myalgias or arthralgias occur in about 15 percent of isotretinoin users. Usually they are mild and tolerable; occasionally they are more severe. Patients may partake in any physical activity they can tolerate, but if pain is severe, isotretinoin may need to be discontinued or the dose lowered.
Athletes who are isotretinoin candidates and are playing contact sports may be best served by using the agent during the off-season. Inform patients that hair thinning occurs in about 10 percent of isotretinoin users.
Usually it is mild and not noticeable to others and it very rarely persists. Rarely, discontinuation of isotretinoin treatment is necessitated by thinning of the hair. I have advised therapy discontinuation most often as a result of the patient's request rather than due to absolute necessity. Decreased night vision occurs in about five percent of isotretinoin users. Caution patients to be careful when driving at night or to avoid driving at night if the condition becomes severe.
It is important that patients avoid wax epilation "waxing" and non-ablative laser resurfacing during and for six months after treatment, due to the risk of scarring. Moreover, they should avoid ablative laser resurfacing, dermabrasion, and acne scar revisions during and for at least 12 months after treatment.
The occasional development of anemia, leukopenia or thrombocytopenia typically is detected with routine complete blood counts. In the unlikely event of marked suppression, physicians may choose to adjust treatment or stop it altogether. Increased triglyceride and cholesterol levels are fairly common and are detected with routine fasting lipid profiles. They occur most often in individuals who have diabetes mellitus, are overweight, or have a personal or family history of high triglycerides or cholesterol.
Elevations are usually mild and of no consequence and will normalize within a month or two after finishing treatment. Rarely, marked hypertriglyceridemia develops, with acute pancreatitis being a potential complication. Signs and symptoms of pancreatitis include upper abdominal pain, pain in the mid-back, nausea, vomiting, fever, jaundice, and icterus.
Inform patients that, with proper monitoring, pancreatitis is completely avoidable. If triglyceride levels are elevated, you may adjust therapy accordingly. A low triglyceride diet may be helpful for patients, so it is useful to provide a low triglyceride diet list. If needed, one of the statins, such as Zocor simvastatin, Merck or Lipitor atorvastatin, Pfizer , may help control these levels.
This is an occasional side effect, most often detected with routine hepatic panel monitoring. Usually the elevated liver enzyme levels are mild and require no changes in therapy. If significantly out of range, dose adjustment or discontinuation of isotretinoin may be necessary. Due to overlapping side effects between isotretinoin and vitamin A, the FDA warns against taking any supplemental vitamin A, even the low dose in multivitamins, when taking isotretinoin.
With appropriate laboratory monitoring and response, risk to the liver is negligible. Most multivitamins contain vitamin A or beta-carotene in the range of 3, IU 70 percent DV in a popular brand-name product up to 5, IU in one specialty organic formulation, according to offerings at drugstore. Make sure to ask your patients about any prior liver problems, such as viral or alcoholic hepatitis or cirrhosis. Request a list of all medications patients are currently taking, with particular attention to any potentially hepatoxic medications.
Patients should avoid excessive alcohol ingestion during treatment, so be open in speaking with patients to ensure they are aware of proper limits. Mood Changes. Patients may experience depression or other psychiatric disorders during isotretinoin therapy, though the link between isotretinoin and depression remains controversial.
Thus, there does not seem to be a statistical correlation between isotretinoin therapy and suicide. Nevertheless, it is important to address any history of psychiatric illness, suicidal ideations or attempts while considering isotretinoin therapy.
Pseudotumor Cerebri. Fewer than one percent of isotretinoin users develop elevated intracerebral pressure. Be sure to review with your patients any prescription and over-the-counter medications they are taking before providing isotretinoin. As per FDA-approved Prescribing Information, antibiotics in the tetracycline family and any supplemental vitamin A, including vitamin A in multivitamins, are contraindicated while on isotretinoin.
Again, a vitamin A-free multivitamin may be taken if the patient wishes to continue a multivitamin during therapy. Pseudotumor Cerebri resolves spontaneously if detected early and isotretinoin is stopped. If such symptoms are ignored or not reported, the condition can slowly worsen and potentially become life-threatening. Neurologic consultation is prudent if there is significant concern.
Fundoscopic examination for papilledema and occasionally an MRI scan may be necessary for further evaluation.
Inflammatory Bowel Disease. Fewer than one percent of patients taking isotretinoin develop inflammatory bowel disease.
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Acne Flaring. While mild worsening of acne occurs occasionally while on isotretinoin, severe flaring acne fulminans also is possible, albeit rare. Explain to patients that usually it will take up to two months before they start to see improvement with isotretinoin therapy. To avert worsening, it is helpful to start patients on a low dose 0. Importantly, communication with patients on this matter is essential.
Occasionally, a limited tapering systemic corticosteroid course may be necessary to control a severe flare. Eye dryness typically is mild, but can occur. Occasionally the dryness causes slightly blurry vision or irritation of the eyes. In these instances, contact lenses, especially hard lenses, may be more difficult to wear. For patients experiencing eye dryness or irritation, artificial tears, such as Celluvisc or HypoTears, may help.
Ophthalmic consultation may be warranted if symptoms do not abate. Musculoskeletal Symptoms. Myalgias or arthralgias occur in about 15 percent of isotretinoin users.
Usually they are mild and tolerable; occasionally they are more severe. Patients may partake in any physical activity they can tolerate, but if pain is severe, isotretinoin may need to be discontinued or the dose lowered. Athletes who are isotretinoin candidates and are playing contact sports may be best served by using the agent during the off-season.
Inform patients that hair thinning occurs in about 10 percent of isotretinoin users. Usually it is mild and not noticeable to others and it very rarely persists. Rarely, discontinuation of isotretinoin treatment is necessitated by thinning of the hair. I have advised therapy discontinuation most often as a result of the patient's request rather than due to absolute necessity.
Decreased night vision occurs in about five percent of isotretinoin users. Caution patients to be careful when driving at night or to avoid driving at night if the condition becomes severe. It is important that patients avoid wax epilation "waxing" and non-ablative laser resurfacing during and for six months after treatment, due to the risk of scarring.
Moreover, they should avoid ablative laser resurfacing, dermabrasion, and acne scar revisions during and for at least 12 months after treatment. The occasional development of anemia, leukopenia or thrombocytopenia typically is detected with routine complete blood counts.
In the unlikely event of marked suppression, physicians may choose to adjust treatment or stop it altogether. Increased triglyceride and cholesterol levels are fairly common and are detected with routine fasting lipid profiles. They occur most often in individuals who have diabetes mellitus, are overweight, or have a personal or family history of high triglycerides or cholesterol. Elevations are usually mild and of no consequence and will normalize within a month or two after finishing treatment.
Rarely, marked hypertriglyceridemia develops, with acute pancreatitis being a potential complication. Signs and symptoms of pancreatitis include upper abdominal pain, pain in the mid-back, nausea, vomiting, fever, jaundice, and icterus.
Inform patients that, with proper monitoring, pancreatitis is completely avoidable. If triglyceride levels are elevated, you may adjust therapy accordingly.
A low triglyceride diet may be helpful for patients, so it is useful to provide a low triglyceride diet list. If needed, one of the statins, such as Zocor simvastatin, Merck or Lipitor atorvastatin, Pfizer , may help control these levels. This is an occasional side effect, most often detected with routine hepatic panel monitoring.
Usually the elevated liver enzyme levels are mild and require no changes in therapy. If significantly out of range, dose adjustment or discontinuation of isotretinoin may be necessary. Due to overlapping side effects between isotretinoin and vitamin A, the FDA warns against taking any supplemental vitamin A, even the low dose in multivitamins, when taking isotretinoin.
With appropriate laboratory monitoring and response, risk to the liver is negligible. Most multivitamins contain vitamin A or beta-carotene in the range of 3, IU 70 percent DV in a popular brand-name product up to 5, IU in one specialty organic formulation, according to offerings at drugstore. Make sure to ask your patients about any prior liver problems, such as viral or alcoholic hepatitis or cirrhosis. Request a list of all medications patients are currently taking, with particular attention to any potentially hepatoxic medications.
Patients should avoid excessive alcohol ingestion during treatment, so be open in speaking with patients to ensure they are aware of proper limits.
Mood Changes. Patients may experience depression or other psychiatric disorders during isotretinoin therapy, though the link between isotretinoin and depression remains controversial. The period of remission takes years for most. Some cases of mild acne may be treated right away with this medication. You may discuss it with your dermatologist. Generally, it will require a low-dose or alternate-day dosing regimen.
What is known today is that isotretinoin does not increase the risk of skin cancer in humans. In fact, retinoids can protect you from this condition.
They stimulate the formation of skin cancer protectants and modulate the immune system. Moreover, isotretinoin has been used to boost the effects of cancer drugs against other tumor types.
An ounce of prevention is worth a pound of cure. And when it comes to preventing acne scars, nothing beats Accutane treatment. But you have to take it with caution and medical supervision. Partner up with no less than a board-certified professional on your Accutane journey. Accutane treatment can help. Visit us at our Encino or Glendale clinic or use our virtual portal for a remote consultation.
Suite Encino, CA If you'd like to be added to our database to receive emails with news about BHSkin products and services, please enter your email address below. Contents How Does Acne Develop? How Does Accutane Work? Does Isotretinoin Cause Cancer? How Does Acne Develop? When any of them is present, the following chain of events may occur: Follicular Overgrowth Factors that can cause cellular overgrowth inside the hair follicle include: Hyperactivity of androgens or testosterone-like hormones Reduced body levels of linoleic acid, a fatty acid that you can get only from the diet Immunologic changes The excess cells do not only grow fast, but they are also unusually sticky.
Inflammation All of the above changes lead to pressure buildup inside the hair follicle and subsequent inflammation. BHSkin Dermatology physicians have a vast anti-acne arsenal , which includes the following: Medicated Cleansers Cleansing the skin twice daily minimizes impurities and oil buildup.
Topical Drugs Topical medications like benzoyl peroxide, erythromycin and clindamycin have antimicrobial action. Hormonal Therapy Some individuals are prone to hormonal acne or breakouts caused by androgen fluctuations. Diet Modification Chocolate, milk, sweets, and fatty meals have all been implicated in breakouts, although the link between acne and food is not entirely clear.
Acne Surgery This procedure removes blackheads and whiteheads to prevent severe acne. Intralesional Glucocorticoids Steroids injected into the skin curb inflammation in big, nodular acne.
Phototherapy and Lasers UV radiation targets P. Systemic and Topical Retinoid Formulations Retinoids are vitamin-A-like molecules that can work wonders on the skin.
Accutane is a brand name of oral isotretinoin. It works at the genetic level to: Normalize cell growth and function in the hair follicles and oil glands. Prevent clogged pores. So when you think about it, those Hollywood Accutane users are right. Get superior skincare from LA's finest dermatologists Book the type of an appointment that suits you best.
Book Appointment Virtual Consultation. Hot showers can increase dryness. When you get out of the shower, pat dry, and apply a thick moisturizing cream all over. Examples of creams we recommend are Cetaphil moisturizing cream and Cerave moisturizing cream.
Apply a thin layer of aquaphor, vaseline, or organic oil ie olive oil to skin just inside the nose. If you need an over the counter pain medication, we recommend ibuprofen. Avoid taking Tylenol while on Accutane. Stop taking the medication and call our office immediately or seek urgent care in the ER if you have a severe headache or a headache associated with visual changes.
Phone: Fax: South Cherry St.
What is Accutane and How Does it Work? Isotretinoin more commonly known as its former brand name Accutane is a drug used to treat severe acne. Isotretinoin works by decreasing the size of the sebaceous glands in the skin. The sebaceous glands are responsible for creating sebum, the oil in skin that can clog pores and cause acne.
When the sebum is controlled, breakouts stop. The drug is found to be very successful in treating acne when all other options have been exhausted. The reason that doctors typically hold off on prescribing isotretinoin is because of the intense side effects it can have on your body.
However, because Isotretinoin has been well monitored, all side-effects are known and can be treated. If you are struggling with severe acne and have exhausted all other options, your dermatologist may speak with you about prescribing Isotretinoin. If you are a good candidate for the medication, you can begin acne treatment. At Apotheco Pharmacy, we will work with you and your dermatologist to ensure you have the best possible treatment outcome.
Contact your local Apotheco Pharmacy retail location or send us a Contact form to learn about our Accutane Program. For everyone, not just teenagers, acne is caused by heredity and hormones. With a family history of acne while going…. Acne can be tiring and frustrating, and many young people ask, when does acne go away? A zit is…. What is Salicylic Acid?
Salicylic acid is part of the beta hydroxy acid family. The hydroxyl part of the molecule…. What is Benzoyl Peroxide? Benzoyl peroxide is a bactericidal substance, meaning that it kills bacteria. Propionibacterium acnes is the type…. This blog is fact checked by our educated Pharmacist in Charge, Darshan Patelwho additionally runs our Apotheco Manhattan location. Here at Apotheco Pharmacy Group, our goal is to provide the most up to date and accurate information on health and dermatology related topics.
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Treating minor complications—your healthcare provider may do the following for non-life-threatening side effects: Give you emollients for flaky or dry skin. You. "Keep skin care simple and basic, avoiding 'active' ingredients," says Dr. Mahto. "The skin is fragile on Isotretinoin, and many of these. "Keep skin care simple and basic, avoiding 'active' ingredients," says Dr. Mahto. "The skin is fragile on Isotretinoin, and many of these. Accutane is a drug found to be very successful in treating acne when all other options fail. Learn about the intense side effects it can. Treating minor complications—your healthcare provider may do the following for non-life-threatening side effects: Give you emollients for flaky or dry skin. You. We're Hiring! When any of them is present, the following chain of events may occur: Follicular Overgrowth Factors that can cause cellular overgrowth inside the hair follicle include: Hyperactivity of androgens or testosterone-like hormones Reduced body levels of linoleic acid, a fatty acid that you can get only from the diet Immunologic changes The excess cells do not only grow fast, but they are also unusually sticky. Street Style. In a gist, they all involve strict protocols for preventing pregnancy during Accutane treatment and vice versa. Systemic side effects are likewise linked to oral isotretinoin therapy, but they are either rare, preventable or manageable. The sebaceous glands are responsible for creating sebum, the oil in skin that can clog pores and cause acne.If you buy a product we have recommended, we may receive affiliate commission, which in turn supports our work. I've had acne for over a decade thanks hormones and PCOS , and through the years, I've learned to mostly control my breakouts and oiliness with the appropriate products. That all changed six months ago when I started taking the intense oral acne medication Isotretinoin — commonly known as Accutane — and all of a sudden I had to figure out how to deal with very dry skin , which is something I've never had before.
My lips have suffered the most, and I've experienced severe dryness around my eyes, nose, face, and body — all of which has resulted in a lot of peeling. To combat this, I've had to get serious about incorporating superhydrating products into my skin-care routine, as well as really simplifying things, making sure every product is gentle, fragrance-free, and, as best as possible, free of potentially harsh active ingredients.
An oral medication, Isotretinoin is an internal retinoid it's retinoic acid, to be exact , which means it's a derivative of vitamin A. I took Accutane about nine years ago, but at the end of , together with my doctor, we decided a second round might be beneficial as I got tired of new spots and the never-ending cycle of pigmentation they left behind. It took me about a year to agree to do a second round, due to the very severe contraindications, ranging from dry skin and dry eyes to painful joints and even depression.
I knew that with proper care and the right ingredients and products, I could handle the overall dryness. Anjali Mahto , a London-based consultant dermatologist, has been on oral Isotretinoin herself and explained why it causes dryness. Lip and skin dryness are extremely common side effects of the medication, and most people on the medication will suffer; it can usually be managed with appropriate skin care and lip care.
Mahto says of the types of cleansers, creams, and lotions to use while on the medication. As previously mentioned, a focus on hydration and nonactive ingredients is very important. And speak directly to your prescribing consultant dermatologist if you are unclear about options. My skin isn't sensitive at all, but because of the treatment, I now take extra care with what ingredients I use so that I don't irritate it.
Keep reading to discover all the products I've incorporated into my routine while on Accutane, along with a few recommendations from Dr. View On One Page. Photo 0 of 8. Previous Next Start Slideshow. You May Also Like. Beauty Trends. Beauty Reviews. Beauty News. Kylie Jenner. My Must Haves. Now You Know. Latest Beauty. Customize Select the topics that interest you:. Celebrity Style. Street Style. Beauty Tips.
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