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For severe or cystic acne, Accutane is a common treatment. Here’s what to know before taking it.

Are you searching for the right acne treatment for your skin? There are creams, gels, pads and pills. Over-the-counter and prescription offerings. And for many types of acne, a simple drug store product may get the job done. But for more severe types, you may need something stronger.

If you have acne that hasn’t responded to other therapies, your healthcare provider may prescribe a medication called Accutane®. 

What is Accutane?

Accutane is a prescription medicine used to treat severe acne. Although it’s no longer sold under the brand name Accutane, many people still refer to it that way. You may also see it called:

  • Isotretinoin
  • Absorica®
  • Clavaris™
  • Amnesteem®
  • Myorisan®
  • Zenatane™

“A healthcare provider may recommend using it if other acne medications or treatments haven’t worked, or you haven’t tolerated them well,” says Swana Thomas, ambulatory clinical pharmacist at Geisinger.

How does Accutane work?

Isotretinoin is in category of drugs called retinoids. These drugs are derived from vitamin A, which helps benefit your skin. “Retinoids work to lessen inflammation, reduce oil production and eliminate the bacteria that causes acne,” says Ms. Thomas.

Several types of retinoids are available, with Accutane (Isotretinoin) being the strongest. Isotretinoin increases turnover of skin cells. That turnover helps you shed dead skin cells and produce new, healthy ones. New cells mean fewer clogged pores and less buildup of oil, resulting in less acne.

What are the side effects of Accutane?

Because Isotretinoin reduces the oil in your skin, you may notice that your skin feels dry. Other side effects include:

  • Sensitivity to sunlight
  • Worsening acne
  • Headache
  • Dry mouth
  • Sore throat
  • Dry eyes or nose
  • Itchy skin or rash
  • Nosebleeds
  • Upset stomach

More serious ones include:

  • Joint pain
  • Thinning hair
  • Worsening nighttime vision
  • Changes in blood glucose or cholesterol numbers

“Contact your healthcare provider right away if you have any serious or worsening side effects or if they don’t go away,” says Ms. Thomas.

Who should avoid taking Accutane?

Isotretinoin may not be right for everyone. Before they prescribe it, your provider will ask you a few questions about your health history. They may not recommend taking it if you:

  • Are pregnant, breastfeeding or planning to get pregnant within the next six months
  • Taking certain medications
  • Have certain medical conditions like high cholesterol, low bone density or inflammatory bowel disease

Because Accutane carries a risk of birth defects, it’s crucial to discuss potential risks with your provider. They may have you enroll in a risk management program to help you avoid pregnancy while taking it. “You’ll be required to use birth control for one month before starting treatment, while you’re taking it and for at least one month after,” Ms. Thomas says.

Your provider may also recommend avoiding alcohol while taking Isotretinoin.

Alternatives to Accutane

Not a good candidate for Isotretinoin? Your provider may suggest another option. Consider these alternatives.

Oral antibiotics

Antibiotics can target the bacteria that leads to breakouts, giving you clearer skin. “Your provider may suggest antibiotics along with other medications to get your skin under control,” says Ms. Thomas.

Hormonal treatments

For acne that won’t go away, a hormonal medication called Spironolactone can help. “Spironolactone can treat hormonal fluctuations that can lead to acne,” Ms. Thomas says.

Your provider may also recommend taking oral contraceptives to help your skin.

Steroids

Another treatment for persistent breakouts? Steroids. Corticosteroids like prednisone work to reduce inflammation. It’s important to note, though, that steroids can sometimes worsen breakouts. To avoid worse acne, they’re often prescribed alongside topical treatments or other medications.

Topical retinoid medicines

Your provider may also recommend a topical medicine to manage acne. These treatments work like Isotretinoin by reducing oil. And they prevent breakouts before they start. Topical treatments come in a few forms, including:

  • Creams
  • Gels
  • Foam

They can be used alone. But they’re often prescribed along with antibiotics or benzoyl peroxide.

Make an informed decision

If you’re considering Accutane, start by talking to your healthcare provider. They can help you explore your options and find the right acne treatment for you.

Next steps:

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