Isotretinoin belongs to a group of medicines known as retinoids which are derivatives of vitamin A. This drug is intended for the treatment of severe acne. Isotretinoin lessens facial oil production. High amounts of sebum can lead to severe acne. If left untreated, severe acne can cause permanent scarring. The Food and Drug Administration (FDA) has already approved this medication. Isotretinoin comes as a capsule for oral use. Each capsule is available in the dosage forms of 10 mg, 20 mg, 30 mg, and 40 mg.
Acne occurs when your hair follicles become plugged with oil and dead skin cells. It frequently causes whiteheads, blackheads, or pimples. It usually appears on the face, forehead, shoulders, upper back, or chest. Acne is most common in teenagers. Acne can cause emotional distress and scar on the skin. The symptoms may be different depending on the severity of your condition;
- Blackheads (open plugged pores)
- Pimples (pustules) which are papules with pus at their tips
- Whiteheads (closed plugged pores)
- Small red, tender bumps (papules)
- Painful, pus-filled lumps beneath the surface of the skin (cystic lesions)
- Large, solid, painful lumps beneath the surface of the skin (nodules)
Seek emergency medical assistance if after using a skin product you experience;
- Difficulty breathing
- The tightness of the throat
- Swelling of the eyes, lips, face, or tongue
These factors can trigger acne;
- Certain medications – those that contain corticosteroids, lithium, or testosterone
- Hormones – androgens are hormones that increase in boys and girls during puberty. It causes the sebaceous glands to enlarge and make more sebum. Hormonal changes related to pregnancy and the use of oral contraceptives also can affect sebum production. Low amounts of androgens circulate in the blood of women and can worsen acne.
- Diet – studies indicate that certain dietary factors may worsen acne.
- Stress – this can also make acne worse.
How does Isotretinoin work for acne?
Isotretinoin works by reducing the production of the skin’s natural oil which is called sebum. You get acne when over-active sebaceous glands in the skin produce an excessive amount of sebum. The sebum blocks the sebaceous glands which stop the oil from flowing freely out. It also causes the sebum to build up under the skin. They feed on the sebum and produce waste products and fatty acids that irritate the sebaceous glands that make them inflamed and cause spots.
This medication reduces the size and activity of the sebaceous glands in the skin which also lessens the amount of sebum that is produced. This stops the glands from becoming blocked. It means that the bacteria are less likely to thrive. It also decreases the inflammation in the skin.
Your acne may get worse when you first start taking Isotretinoin. But, it usually starts to improve within 7 – 10 days of treatment. Most people discover that their acne clears up with a 16 – 24 week of treatment. You’re then likely to remain free of acne for a long time. Repeat courses are not usually recommended unless a definite relapse is seen after treatment is stopped. Repeat courses should not be started until at least 8 weeks after the previous course as your acne may still improve at this time.
How to use Isotretinoin?
The dosage is based on your condition and response to the treatment. This medication is to be taken exactly as it is prescribed by your doctor for the best result. Isotretinoin is usually taken twice a day for 15 to 20 weeks or as directed by your doctor. This drug may be taken with or without food. Take this medication with a full glass of water and do not lie down for at least 10 minutes after taking it.
Swallow the capsule as a whole with a full glass of water. Do not crush, break, or chew it. Be sure to tell your doctor about all the products you use. Do not increase your dose, take this drug more often than prescribed, or stop taking it even for a short time unless directed to do so by your doctor. If you missed a dose, call your doctor right away for instructions. Do not double the dosage to make up for the missed dose.
What are the side effects of Isotretinoin?
Common side effects:
- Thinning hair
- Upset stomach
- Swelling of your eyelids or lips
- Crusty skin
- Changes in your fingernails or toenails
- Dryness of the mouth, lips, skin, or nose
- Cracking or peeling skin
- Joint or back pain
Inform your doctor at once if these occur;
- Mental/mood changes
- Tingling feeling in the skin
- Quick or severe sunburn
- Painful swallowing
- Signs of infection (fever and persistent sore throat)
- Peeling skin on palms or soles
- This medication may make you more sensitive to the sun. Limit your time in the sun. Use sunscreen and wear protective clothing when outside.
- Isotretinoin can affect your night vision. You should not drive or use any machinery after dark until you are sure you can do it.
- Avoid alcoholic beverages while having this medication. Alcohol could increase the risk of developing liver problems or raised cholesterol levels.
- You should not take vitamin A supplements while you are taking this drug. It may result in a condition similar to vitamin A overdose which may cause changes in the structure of the bone.
- Avoid using other conventional acne treatments. You can use non-irritant preparations on your skin if needed and it is fine to use moisturizers.
Isotretinoin is suitable for adults and teenagers. It should not be taken by:
- Women who are pregnant or breastfeeding. The medication can be harmful to a developing baby and it gets into breast milk can be harmful as well to a nursing baby
- Children under 12 years of age and children with acne that has developed before reaching puberty
- People with high levels of fats such as cholesterol or triglycerides in their blood
- People with liver problems
- People with a condition resulting from the excessive consumptions of vitamin A
- Those who are taking tetracycline-type of antibiotics
- People who are allergic to any of the ingredients of this drug