Everything you need to know about starting Accutane

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You’ve tried everything – expensive cleansers, benzoyl peroxide spot treatments, infomercial-approved Proactiv – and you look in the mirror wondering why none of it worked. Your acne has become a nagging problem and your only solace is a dimly lit room.

And then your dermatologist recommends Accutane—one of the most extreme measures to get rid of those volcanic pimples once and for all.

But what is Accutane? And what about all those rumors that it causes dry skin or depression? And why is it considered the gold standard for acne remedies among the many cheaper treatments available at your local drugstore? Here’s your guide to everything you’ve always wanted to know about taking Accutane and why it’s less terrifying than you might think.

I want to try Accutane, but what is it exactly?

According to the dermatologist Debra jaliman, MD, Accutane is a derivative of vitamin A that patients take orally (often twice a day). You might find that the name Isotretinoin is also used interchangeably – the “Accutane” branded product is no longer on the market, in fact. It’s just the name most of us know now.

Isotretinoin is intended for reduce inflammation and the number of bacteria in your pores, thus eliminating any acne problem. The dosage and treatment depends on the person. If your problem is severe, you may be given a higher dose, although Jaliman added that it is often only recommended for patients with severe acne problems who have not used other treatments.

Why does it work so well?

It’s effective because it attacks acne on all fronts, according to dermatologist Joshua Zeichner, MD “It attacks all of the major factors responsible for acne, including the production of sebum, acne-causing bacteria, sticky cells blocking follicles and inflammation,” he said. declared. Part of the fear factor around isotretinoin is its side effects, which can be serious, according to the dosage recommended by your doctor.

What kind of side effects are we talking about?

A common side effect is dryness of the skin and lips: OYou will need constant hydration throughout treatment (and often after treatment too), so take lip balm wherever you go.

The list of The potential side effects of isotretinoin are long and a bit scary, but many of them are quite rare. According to Jaliman, you might experience physical side effects like joint stiffness, loss of appetite, headache, light nosebleeds, eye irritation, temporary thinning of hair, increased sensitivity to the sun, and blurred vision. It also increases the level of triglycerides in your blood (a type of fat), which could mean greater effects on cholesterol, which could increase the risk of heart disease and liver damage. She added that there are some have also reported side effects related to mental health, like depressed mood, trouble sleeping and concentrating, and general changes in behavior – which, yes, all seem a little scary at first, but we will come back to it shortly.

For women, the drug is much more dangerous, due to the high risk of birth defects and miscarriage. “Patients should ensure that they continue to use the birth control methods discussed with their doctor,” she said. “Preventing pregnancy is crucial. “

For this reason, women should perform two negative pregnancy tests per month before receiving their first month’s supply. Throughout treatment, women are required to commit to two forms of birth control and a monthly pregnancy test (as well as one after the end of treatment). You’ll also need to complete a monthly questionnaire, which we’ll get to in a moment.

Wait, could that cause depression?

The results, for the most part, are mixed. In the past, depression and an increased risk of suicide have been bound to Accutane, but there is no evidence that it cause them (which is confusing, a 2017 study found that isotretinoin was not associated with an increased risk of suicide, which calls into question the supposed link).

“In all my years of treating a patient with Accutane, I have never seen anyone get depressed about it,” Jaliman added. “If anything, I saw their mood change for the better once they saw their acne go away. Patients who are depressed and undergoing psychiatric treatment often get approval to start Accutane and are closely monitored. I don’t think the risks should scare them away.

However, if you have any concerns, be sure to let your dermatologist know before starting any treatment.

What should I do first if I am interested?

Consult a dermatologist and find out what dosage you would take and how long you should take it. A low dose may mean you are on treatment for longer, while a high dose means the opposite (a low dose, incidentally, could mean reduced side effects, according to Zeichner).

There are also a number of lifestyle changes that you will need to consider before starting any treatment. Because of its effects on your triglycerides and your liver, you are often not supposed to drink or take extra vitamin A supplements, Jaliman said.

In addition, you will need to check if your health insurance covers isotretinoin, as the pill is not cheap without it (usually a few one hundred dollars for a single month of treatment, depending on the dosage and your insurance).

There is also the investment in time that you will need to make as well.

What does the time investment look like?

Every month that you take isotretinoin, you need to go to your doctor’s office for a blood test (mainly to check the numbers for your cholesterol and liver function, Zeichner said). As mentioned, if you are female, you will also need to take a pregnancy test at the office every month.

Men and women are responsible for completing a monthly questionnaire about your experience, as part of the IPledge Program. In order to receive your medication, you and your doctor are both responsible for filling it regularly (this is fairly straightforward, but you can’t forget to finish it or you may miss a month’s supply).

Can I expect immediate results?

It depends, it took me two months to see results. “Some people notice [improvement] a few months after starting treatment and some do not notice great results until they have completed the whole course, ”Jaliman said. In other words, you may need to undergo treatment for six months before you see any sign of it working.

Some also get worse before they get better, she added. Some users experience an initial breakout or “purge”At the start of treatment. It’s temporary, however, and only lasts a few weeks.

What can I do to save my skin while I am in treatment?

Hydrate yourself! You should always have some sort of lip balm on you. The strategist has also put together a few recommendations, including gentle face creams, moisturizers, and Aquaphora (maybe the most needed) – it’s a mixture of petroleum jelly and mineral oil and works both as a general moisturizer, as well as a lip balm and makeup remover.

“It’s important to use a gentle cleanser and moisturizers to help keep your skin barrier in good condition,” Zeichner said. “If you develop an itchy rash, your doctor may also give you a prescription cream to help calm the inflammation and reduce the itching.”

Will it save my skin forever?

I have had treatment twice (once at 16, again at 21) and have rarely had a breakout since. Still, the results of my first treatment left a lot to be desired, so it’s not foolproof, especially not at first.

A 2014 study which followed 146 patients with severe acne found that 96.4 percent of them experienced complete resolution of their acne with a low dose of isotretinoin. In a 5-year follow-up, however, 7.9 percent had experienced some form of relapse. According to Initiated, some doctors claim that their patients’ relapse rate is between 20 and 33%. Still, the odds seem pretty good if it’s something you’re considering and willing to put in the time (and money).

And if you still have doubts, again, talk to a dermatologist and find out if this is something you can treat. It’s not easy, but compared to another year of unnecessary acne medication, it might be worth it.

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About Sally Dominguez

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