Isotretinoin (Accutane®, Claravis ®, Absorbica ®, Myorisan ®) is the most effective medication for acne and is the only curative acne medication available. It is used in people with severe scarring acne, and people who have tried many other treatments but still have continued acne. It causes birth defects if a woman gets pregnant while on the medication, so it is regulated by the government program called iPledge. People of childbearing potential who are sexually active with men while on isotretinoin must use two highly effective forms of birth control for one month prior to starting the medicine, the whole time that they are on the medication, and for one month after stopping the medicine. Isotretinoin leaves the system in 30 days, so it does not cause any long-term problems with birth defects. Because of the risk of birth defects, people of childbearing potential also have to wait one month before starting the medicine.
Isotretinoin's main side effect is dryness of the skin, eyes, lips, and nose. For dryness of the skin, Dr. Chibnall recommends Vaseline or Vanicream moisturizing cream. Sometimes, the skin gets so dry, you can develop something called “retinoid dermatitis.” In these cases, she prescribes a topical steroid to help reduce the inflammation.
For dryness of the nose and or nosebleeds, Dr. Chibnall recommends Ayr moisturizing nasal gel spray. You may also want to keep some Afrin handy since that can stop nosebleeds quickly, should they occur at school (Afrin is not for long term use).
For dryness of the eyes, Dr. Chibnall recommends Refresh Plus preservative free eye drops or, if you wear contact lenses, Refresh contacts. For severe eye dryness, you can try Refresh P.M.
For dryness of the lips, Dr. Chibnall recommends Vaseline lip therapy advanced formula (no fragrance, dyes, or additives) and Dr. Dan’s Corti-balm.
Accutane also makes the skin very sensitive. It is important to not get waxed, pierced, tattooed, or microbladed while taking isotretinoin. Do not have dermaplaning done, and do not place glue-ins in your hair. To remove unwanted hair while on Accutane, it is OK to shave, pluck/tweeze, or thread.
Prior to any surgeries, be sure to let your surgeon know that you are on accutane. Some surgeons prefer to wait 6 months after isotretinoin therapy is complete to perform any non-emergent operations.
Sometimes, accutane can cause inflammation of the nail beds. This painful nuisance is usually due to dryness of the skin and cuticles and can be prevented with Vaseline rubbed around the nails before bed at night.
If your triglycerides (the amount of fat in your blood) becomes elevated, Dr. Chibnall will recommend you take 600mg-700mg of Omega-3 twice a day, such as two Nature Made 1000mg Fish Oil capsules, or one Nature Made 1400mg Flaxseed Oil capsule