Isotretinoin is considered perhaps the most effective modern treatment for acne, in that it is indicated to clear up or significantly positively impact severe cases of acne in as many as seventy-five percent of all cases. It is most commonly known by its original United States brand name, Accutane, and the international name Roaccutane, as produced by Hoffmann-La Roche. As of 2002, its proprietary patent has expired, and it is now sold under numerous generic brand names, including Oratane and Isohexal.
Before the availability of the drug, the treatment of acne was largely limited to the treatment of the bacterial side of the problem--the elimination of Propionbacterium acnes, the bacterium responsible, in some part, for the condition. Many decades of such treatment, however, seem to have produced more resistant strains of that bacterium, and so such treatment is not always effective.
Isotretinoin actually derives in its way from another treatment, which involved a large dose of vitamin A. This treatment seemed to greatly reduce the body's production of sebum (skin oil), which seemed to help many patients to control their acne. However, at the levels of application necessary to produce positive effects, side effects were sometimes severe, mostly stemming from the reduction of skin oil produced by the sebaceous glands.
Accutane is synthetically derived from vitamin A, but while producing greater results, seems also to have fewer side effects. It shrinks the sebaceous glands and reduces their production of sebum in much the same manner, thus producing a decrease in the overall appearance of acne.
While isotretinoin promises great benefits to sufferers of acne, it is generally reserved for use on only the most severe cases. This is due to a number of factors, including its extreme expense, rather larger potential for side effects than some other treatments, and its overall potency--while Accutane may reduce the appearance of your acne, it will invariably dry the skin, potentially to the point of irritation or peeling.
Accutane's press has also been plagued with some of its rarer side effects, which by report include the increased potential for depression and suicide, even potentially in patients with no known history of depression or suicidal tendencies. All indications seem to be that these incidences are exceedingly rare, but anyone taking the drug is required in most locations to be informed of this risk before its use. There is speculation that the risk of depression may be linked to the fact that many individuals with severe acne may already be suffering depressive symptoms. There is also an extremely high instance of birth defects to any pregnancy during which isotretinoin was taken, and as such two methods of birth control should be practiced fully whenever the drug is used by a female to minimize the risk of pregnancy. The risk of general side-effects has been known to increase when the drug is taken along with vitamin A, due to their molecular similarity, and so the use of any such supplement is strongly contra-indicated.
Accutane is a strong drug, and should be reserved for cases of acne that demand strong treatment. Regardless of a physician's recommendation toward the drug, one should also be personally educated with its indications and contra-indications, and one should use considerable caution in approaching it as an alternative.
