What Is Isotretinoin and How Does It Work?
Isotretinoin is a retinoid medication derived from Vitamin A, commonly recognized under various brand names such as Roaccutane, Accutane (USA), and Reticutan. Its primary mechanism involves reducing sebum production—a natural oil produced by the skin—as well as decreasing keratin production, the protein responsible for the outer layer of skin that can contribute to clogged pores.
Indications for Isotretinoin
Isotretinoin is licensed for the treatment of severe acne in individuals aged 12 and above when other treatments have proven ineffective or when there is a significant risk of permanent scarring. Occasionally, dermatology professionals may recommend isotretinoin for uses beyond its licensed indications, and you will be informed accordingly.
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Important Considerations Regarding Isotretinoin
- Pregnancy Precautions: Isotretinoin is contraindicated in pregnancy and should not be taken by individuals attempting to conceive, as it poses serious risks to fetal development.
- Sharing Medication: Isotretinoin capsules should never be shared with others.
- Blood Donation: Patients must refrain from donating blood while on isotretinoin and for at least one month following cessation of the medication.
- Alcohol Consumption: Both isotretinoin and alcohol can exert effects on liver function; therefore, it is advisable to limit alcohol intake to a maximum of 14 units per week.
- Allergy Considerations: Isotretinoin capsules contain processed soya; individuals with peanut or soya allergies should consult their dermatologist.
- Avoid Certain Procedures: Waxing, epilation, dermabrasion, tattoos, and piercings should be avoided during and for up to six months post-treatment due to the potential for skin irritation and scarring.
- Driving and Night Vision: If your occupation requires night vision (e.g., driving, aviation, or operating heavy machinery), consult your employer before commencing isotretinoin therapy, as the medication may affect night vision.
Concurrent Medications
While most medications can be safely taken alongside isotretinoin, certain medications should be avoided, including:
- Tetracycline antibiotics (e.g., lymecycline, doxycycline).
- Vitamin A supplements.
- Certain topical acne treatments that may increase irritation.
Always inform your healthcare provider and pharmacist of your isotretinoin treatment before starting any new medications.
Common Side Effects
- Dry lips (chapped or split).
- Dry skin, which may be more sensitive than usual.
- Dry eyes.
- Increased sun sensitivity.
- Musculoskeletal discomfort (back, muscle, or joint pain).
- Changes in laboratory tests, including mild liver enzyme elevations and altered blood lipid levels, typically resolving after discontinuation.
Rare and Serious Side Effects
In rare cases, isotretinoin may lead to more severe side effects, including:
- Allergic reactions (rash, swelling, difficulty breathing).
- Inflammation of the liver (jaundice, fatigue).
- Vision changes, particularly decreased night vision.
- Gastrointestinal symptoms (nausea, vomiting, diarrhea).
- Symptoms of increased intracranial pressure (severe headache, vision changes).
- Mental health changes, including anxiety or depression.
If you experience any serious side effects, discontinue isotretinoin and consult your healthcare provider immediately.
Sexual Function Considerations
Some patients have reported sexual function issues while on isotretinoin, although the frequency of such reports is not well-established. If you experience any difficulties with sexual function, please discuss this with your healthcare provider.
Information for Individuals of Childbearing Potential
Pregnancy Prevention: Isotretinoin poses significant risks to fetal development. If you are capable of becoming pregnant, you must engage in the Pregnancy Prevention Programme, which includes:
- Enrollment in the programme.
- Regular pregnancy testing.
- Discussion of effective contraception prior to treatment initiation.
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