Mar 10, 2004

The Bottom Line Weigh the pros and cons of taking Accutane for moderate to severe acne before deciding if this potentially dangerous is for you.

Disclaimer: I am not a physician, so I don't treat or diagnose diseases. What follows is simply my own personal experience while taking Accutane. Your results and side effects may be different than mine.

Ever since I was a young teenager, I've been chronically plagued with super duper oily skin and the unsightly acne that goes along with it. Of course these years are hard enough on the self esteem without having to deal with this common skin problem on top of everything else. My mom always told me I'd grow out of it, so I kept patiently waiting for the day I'd finally wake up with clear skin. But that day never came. And as a young woman in my early thirties, I finally decided enough was enough after trying virtually every available over-the-counter product for the treatment of acne there was. My acne was controllable for the most part throughout my twenties, but I had recently started breaking out with ugly nodules along my jawline and they just wouldn't go away. I had just started taking my teenager daughter to the dermatologist for the same problem I had as a teen and found out quickly that her doctor could help my problem as well. Since I was older, we decided to skip more conservative treatments like antibiotics as well as topical creams and go for the big guns right away once he made sure a hormonal imbalance wasn't the problem (think lots of blood work and needle sticks!). I'd heard about many of the side effects of a popularly used acne drug called Accutane (or isotretinoin, the chemical name), but I was willing to give it a try nonetheless. For my younger sister had successfully taken it years ago with amazing results, so I had high hopes for myself as well. Read on to find out more about my overall positive six month course on generic Accutane called Amnesteem I took last year.

~~~What Is Accutane?~~~

For anyone not familiar with what types of skin problems Accutane is commonly prescribed for, here is some information I found on the web that may be of interest. This is **an oral drug specifically designed to combat severe nodular acne. Nodular acne is a particularly strong form of acne that can lead to lesions and permanent scarring and does not respond to antibiotics, the traditional acne medication. Since the early 1980s, Accutane has been considered a breakthrough drug that could permanently clear severe acne unresponsive to other treatments. However, since its approval, Accutane's growing list of side effects has come under close scrutiny by the FDA. Accutane is a synthetic form of vitamin A, which can be very beneficial in measured doses. Accutane is designed to literally "dry up" certain skin oils (sebum) that clog pores, leading to infection and acne. Unfortunately, while Accutane is effective at treating acne, it has been linked to multiple dangerous side effects, some life-threatening.** But thousands of people, including myself, have successfully taken this prescription drug while only suffering a few minor side effects, which I'll mention below.

**Taken from this URL:

~~~Major Side Effects to Consider~~~

There are many restrictions currently in place regarding the prescription drug Accutane, and with understandable cause. If female patients get pregnant while taking this potent medication, severe birth defects in the unborn child can occur. Other physical side effects include liver disease, hearing and/or vision problems, inflammatory bowel disease, and other systemic diseases of the skin, kidneys, and immune system too numerous to mention. And there can be psychological problems as well, including depression and even suicide in some cases. Of course Accutane is usually prescribed for teenagers just because acne most often occurs in this age group, who may be predisposed to depression and suicidal tendencies in the first place just because of their age group, so this may or may not be coincidence to keep in mind. But at any rate, just like when taking most other drugs, there can be side effects both major and minor that can occur when taking Accutane. Just make sure to weigh the pros and cons very seriously first and see if you might possibly be high risk. Your dermatologist will ask many questions as well as do lab work with each visit to make sure you remain a good candidate for treatment. So just anyone can't walk into the door and get a prescription for Accutane without passing several screening tests first. There's even a thorough contract everyone must sign saying you've been informed of the potential risks and/or side effects.

~~~Affording Accutane~~~

Unless you have health insurance, I doubt most people with average salaries could afford to pay for a six month treatment with Accutane out of pocket since it can be very expensive! Not only are you visiting your dermatologist once a month for tests and to pick up a new 30 day supply prescription, but the medication itself is far from cheap. I took the generic version called Amnesteem and was lucky enough to only pay $5 a month for it with my drug card (and of course my $20 co-pay to my doctor for each visit). Imagine my shock when I saw that my pharmacy charged my insurance company around $432 a MONTH for the generic form of this drug! I can't even begin to guess what the brand name costs, which I'm assuming is substantially more than the generic. So having health insurance is almost a requirement before beginning a course of Accutane as it is far from affordable for most working class people like myself. Otherwise there's NO way I could have came close to affording the monthly pharmacy bill.

~~~What an Average Doctor's Visit Consists Of~~~

Females especially must be carefully screened with each visit while taking Accutane because you must absolutely NOT become pregnant while taking this drug. Since many serious birth defects have been documented, (including mental retardation and head deformaties, just to name a few) sexually active women are required to use not just one but TWO forms of birth control. Even teenage girls who aren't sexually active are often still required to take oral contraceptives "just in case." Meeting these requirements is a bit easier on women who have had a hysterectomy or if their partner has had a vasectomy, but otherwise females have to take a pregnancy test every month while on this drug (and have had TWO negative results before beginning). I was instructed to begin my treatment the week AFTER my period late last April just to reduce any possibility that I might be pregnant even though I'd already been on "the pill" for years after the birth of my youngest child. Blood was drawn at each visit to monitor things like cholesterol (it often goes up, and mine did somewhat but I had a low baseline, which was good) and liver enzymes especially, along with other pertinent values. And of course the nurse would ask me several questions about any side effects I might be experiencing with each visit to monitor for any changes. So expect lots of questions and tests as Accutane definitely isn't for everyone.

~~~Minor Side Effects~~~

I must say that I was rather lucky and the worst side effects I suffered while taking generic Accutane were dry eyes, dry lips, and sun sensitivity. But I could easily prevent or treat these problems, so I decided living with them for awhile was worth the end result. Since I wear contact lenses, I made sure I had several containers of eye drops to treat any dryness (one in my purse, one in my bathroom, one at my computer screen, etc.). And I did the same with lip balm as my lips would get all nasty and peel otherwise if I didn't keep them moisturized (check out Dr. Dan's Medicated Lip Balm for soothing relief as it was a life saver for me!). The hardest thing for me was staying out of the sun (or lathering up with plenty of sunscreen) that summer as I do enjoy getting tan while on vacation, etc. My face, neck, and chest would turn beet red when exposed to just a few minutes of sunlight, so I learned quickly to stay in the shade. But it was a small price to pay in order to have clearer, less oily, skin for life, so I made adjustments that I could live with while dealing with the few minor side effects I experienced when taking Accutane. Only I did manage to get conjunctivitis (ie..."pink eye") not once but TWICE while on this drug (no doubt the dryness played a role), so that wasn't a very pleasant, or pretty, experience!

~~~My Personal Accutane Regimen~~~

Accutane usually comes in 40mg capsules and can be prescribed in many different ways. I would take one pill on "odd" days of the month while taking two pills on the "even" days. Taking each dose with food increases absorption, so I took great care not to take it on an empty stomach. And depending on the severity of each individual case of acne, the dosage can be increased or decreased. But I found my own personal regimen worked best for me as it kept any drying side effects under control. There's even a maintenance regimen some people follow AFTER treatment (a few capsules a week), but thankfully once my six month treatment was over, my face has stayed 95% clearer than it had been before (some people will require TWO treatments several months apart). Yes, I still get a few breakouts now and then while are probably hormonal, but it's nothing like those deep nodules I was getting that would last for WEEKS on end before finally going away, leaving ugly scarring in the process. It took a good two to three months to even begin to see results (which can be quite frustrating in the beginning as I wanted immediate results after waiting YEARS for my acne to go away!), and by the end of six months, I could really tell a big difference as my skin wasn't near as oily as it had been in the past and my pores were no longer clogged with gunk. I can actually walk out of the house without make-up on now without feeling self conscious about my appearance. Darn well time! So without hesitation, I can easily recommend Accutane to others once other less serious treatments have been tried first.

~~~Overall Thoughts~~~

Make sure you are willing to follow the "rules" exactly for the long haul while taking Accutane and chances are you'll be pleased with the long term results. Each pill comes individually wrapped (and down right HARD to remove, at that!) with a daily dosage reminder that females are NOT to become pregnant while taking this drug. So abstinence or responsibly using two forms of birth control the entire time is a MUST: no forgetting or getting lazy is allowed. And if you happen to notice any dangerous side effects like depression or suicidal thoughts, PLEASE call your physician right away to prevent any serious consequences. So thoroughly weigh the pros and cons of taking Accutane with your doctor as this isn't a decision to be made lightly. Good luck and stay healthy :-)

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