by Ndidi Ngwuluka

Created on: January 17, 2009   Last Updated: April 03, 2010

Although drugs are employed for treatment and management of diseases, most of them can also generate unwanted effects. One of such drugs is Isotretinoin which is also known as accutane or amnesteem or sotret or claravis. These names are given to isotretinoin by the various pharmaceutical industries.

Isotretinoin is a medication used in the treatment and prevention of severe acne. Acne commonly known as pimples is the inflammation of the skin which occurs when the follicles are blocked by the build up of oil on the skin. How isotretinoin is able to treat acne is not certain. However, it is believed that it reduces oil secretion from the oil glands. Less secretion of oil will lead to fewer blockages of the follicles and subsequent reduction in inflammation.

Isotretinoin is very effective in treatment of acne; in fact for most patients, it can cure acne for good. However, based on the side effects, isotretinoin has to be given under close supervision of a dermatologist. The common side effects include dry lips and skin, itching, nose bleeding, peeling of skin on palms and toes, joint pains, decreased night vision, reduced tolerance to contact lenses and increase in blood cholesterol and triglycerides. These side effects stop when isotretinoin is discontinued.

However some side effects if not treated, persist even after the drug is stopped. These include nausea, vomiting, inflammatory bowel disease, depression such as feeling of sadness or irritability, unusual tiredness or lack of appetite, yellow colour on the skin or eyes and dark yellow urine, hair loss and keloids.

Some rare side effects include hallucination, suicidal behaviour, menstrual disturbances, hepatitis, inflammation of the pancreas, skin infections, sensitivity to sun, hearing impairment and difficulty in maintaining erection.

Isotretinoin is harmful to the foetus and so should not be used in pregnancy. It can cause severe birth defects such as malformation of the head and face; and internal defects of the brain, nerves, heart and glands. A patient should avoid being pregnant one month before and after the use of isotretinoin. Furthermore, due to the potential serious effects of isotretinoin, it is not recommended for breastfeeding mothers.

Isotretinoin is a derivative of Vitamin A and so Vitamin A supplements should be avoided during the treatment to avoid increased toxicity.

As much as it has been stated that isotretinoin can cure acne for good in most patients, the potential adverse effects reduces its usage to when all other acne medications has failed. It may be better to have acne than to develop unwanted side effects which may be permanent.

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