Almost everyone in high school has experienced acne. The lucky ones get a little peppering while the less fortunate get much more. Some high school kids will do anything to get rid of this facial affliction: lotions, pills, creams, or all of the above.
One popular choice for the harder cases is isotretinoin, often referred to as Accutane even though the brand Accutane is no longer sold in theUnited States. According to WebMD, the drug giant Hoffmann-La Roche stopped selling Accutane in 2009 because of a number of lawsuits related to the drug.
It turns out that while this drug has worked wonders for some, recent studies show that it might be more of a nightmare for others.
Drug is effective for severe cases
Although Accutane is off the market, isotretinoin is still available in generic form from several manufacturers. Karl Kellawan, a Centerville dermatologist, prescribes the generic medicine, which he still refers to as Accutane.
“Accutane is reserved for extremely bad nodular cystic acne,” said Kellawan. Nodular acne is a very severe type of acne that can often be painful. Teens and adults alike have used Accutane or its generic form to get rid of strong cases of acne.
The drug, a synthetic form of vitamin A, works by reducing the amount of oil produced by the oil glands, allowing the skin to regenerate the way it’s supposed to, reducing inflammation and pustules.
The numbers suggest that isotretinoin works wonders as far as getting rid of acne. “Accutane always works well, with few exceptions,” said Kellawan. According to WebMD, more than 80 percent of patients see a decrease or elimination of acne.
“I haven’t had a breakout since I stopped taking Accutane,” said Fairmont senior Colleen Murphy, who took the drug last year.
Isotretinoin also works in reducing facial scarring, an issue that plagues people even after acne clears. “My complexion was awful … but I used it once for six months, and I haven’t had a problem since,” said senior Natalie Rohr. Rohr said she had her treatment during her freshman year.
Isotretinoin’s side effects can be serious
But for all of its pluses, isotretinoin also has some downsides that can ruin the deal for a lot of people.
The most common side effect of isotretinoin is that users get really dry skin. “I started in the winter so everything on my body was chapped and I had really irritated skin,” said Fairmont senior Adam Donovan, who was treated during his sophomore year. Users may have to use lotion to counterbalance this dryness.
In addition, many users will experience fatigue. “The worst part was I couldn’t work out,” said Murphy. “My muscles ached and I couldn’t do some of the lifting required for my work. Sometimes it was hard for me to even lift my backpack.”
Isotretinoin can also lead to higher levels of triglycerides. Triglycerides are fats found in the blood that can lead to a higher risk of heart disease or stroke. “They wouldn’t fill the prescription without the blood test,” said Donovan.
In addition, isotretinoin can cause severe birth defects, so users must use birth control – birth control pills for women and condoms for men – and sign up for the iPLEDGE program. The iPLEDGE program is a web-based risk management program made to keep women from either starting isotretinoin while pregnant or getting pregnant while on isotretinoin. “I had to get my blood checked once a month to make sure I wasn’t pregnant,” said Murphy. “They were really strict. I had to keep coming even after I was off Accutane.”
Other severe side effects can include depression, psychosis and suicidal thoughts. People with a history of depression should know that it can worsen due to isotretinoin.
Kellawan says the acne drug has also been linked to bowel problems. “The biggest negative is that Accutane is possibly associated with ulcerative colitis, a bowel disease manifested by abdominal pain, and occasionally it can require surgery,” he said.
But acne can be harmful, too
After Hoffmann-La Roche pulled Accutane off the market in 2009, a doctor who chaired the American Academy of Dermatology committee that studied Accutane’s safety said it would be a “true disaster” if acne sufferers didn’t have access to the drug. “People don’t die of acne, so it’s easy to say, ‘This is a drug that causes inflammatory bowel disease; let’s take if off the market,’ ” Dr. Steven Stone told the Seattle Times. “But that ignores the psychological harm of severe acne.”
Kellawan agrees that the “side of effects [of acne] are insecurity and low self-esteem.” By getting rid of acne, many students will have higher self-esteem and possibly become more social. Many people are more likely to come out of their shells knowing that others won’t be apt to criticize them on their acne.
Some patients, however, are up in arms about what Accutane has done to their bodies and have taken legal action. Hoffmann-La Roche faces many class action lawsuits (when groups of people join together to form one lawsuit); DrugWatch.com says an estimated 5,000 personal injury lawsuits have been filed involving Accutane.
In the end, isotretinoin can be a risk, but it’s one that many people are willing to take. “The side effects may be bad,” Rohr said. “But they’re really rare and it really works.”