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This drug appears to be the solution to all my problems. I started this January on 80mg a day. So far I have seen fantastic improvements. I have done quite a bit of research on the topic and below I detail my findings. I am still in the middle of my course of treatment but hopefully I will finish in July. I will update this page as things progress.
What is it?
 | Isotretinoin in its tablet form is usually referred to as Roaccutane in the UK. Abroad it is often referred to as Accutane, which is the US version of the drug, and also RoAcutan in Italy. |
| In the UK it is available in 20mg and 5 mg capsules. Abroad it is also available in 2.5mg, 10mg and 40mg capsules, depending on the country. |
| They are available in blister packs (individually sealed to be pushed through the silver foil) of seven per sheet and boxes of 8 sheets making 56 in total. |
| The dosage should be determined between you and your consultant but is usually between half and one mg per kg of your weight e.g. 180lbs = 82kg = 41mg to 82 mg dosage. |
| It is not known exactly how the medication works but it seems to work on a principle of ensuring that you take an amount of the drug over time not just a set quantity each day. |
| The amount taken in total should be 100mg - 120mg per kg weight. So based on the above example if the person was assigned a daily dosage of 60mg then the course would last for 20 - 24 weeks ( 8200 - 9840mg by 60mg = 137 - 164 days) which is reflective of the usual 4 - 6 month course. |
How does it work?
This is a good question. Nobody is 100% sure of how it stops acne but it does. It does reduce the size of the sebaceous glands. Now there is some question as to whether sufferers of acne have particularly large sebaceous glands in which case this is restoring them to Joe Public's size or whether the are being shrunk smaller than they should. I don't know myself but the net result is a reduction in sebum over production.
Being a Vitamin A compound it promotes the regeneration of skin cells. Unfortunately this not only improves the standard of your skin but also causes flakiness. (See side effects below). It also has some anti-bacterial and anti-inflammatory benefits, so preventing skin infections and reducing swollen spots.
The side effects
This is the area that frightens most people off taking the tablets. But you've got to weigh up whether the benefits outnumber the difficulties. I can't decide for you only that I decided it was worthwhile after all the other treatments I'd tried and I decided that if it worked I could cope with six months of discomfort. The stronger the dose the greater the side effects.
Dryness causes the greatest problems. The dryness may not start until a couple of weeks into the treatment but you'll soon notice your lips become very chapped and your skin dries. You will also notice the inside of your nose drying and your eyes becoming quite dry.
You can solve the skin dryness by using a good unscented moisturiser. Be careful if using a fragranced moisturiser as they normally have alcohol in them, which can aggravate and neutralise the moisturising effect. For your lips petroleum jelly is excellent but I particularly recommend Chapstick lipsalve in a tube and Blisteze, which work better. Remember to use plenty at night, as your lips will soak up the moisture during the night.
I haven't found much to help with the nose. Some people find a small amount of petroleum jelly can help if smeared just inside the nose. However don't be surprised if you have a problem with small nosebleeds when you blow your nose. This is the dry mucous membrane cracking as you blow. It will heal itself naturally. If however, you find yourself having spontaneous nosebleeds then tell your doctor or consultant as this could be a sign of problems in your blood and you may need your dosage adjusted.
Drying eyes are only a real problem if you wear contact lenses. I found that after about three weeks I had to stop wearing my gas permeable lenses because my eyes were constantly dry and itchy and no matter what eye drops I tried nothing helped. Some people have managed to continue wearing their lenses with the use of eye drops or just limit the wearing to small periods of time. I happen to use a V.D.U. screen most of the day in work and that most likely compounded my problems. If you're unsure have a chat with your optician or consultant and get their view and see how it goes but make sure you've got up to date prescriptions in your specs before you start as you may be caught out later!!!
Other side effects can involve headaches, joint aches, nausea and hair loss. These are less frequently experienced but all the same possible. I've personally had joint aches and a little nausea, but I found taking the tablets straight after food in the evening helped to stop the nausea and keeping my joints mobile and warm made them ache less often. Another side effect I've experienced which doesn't seem to have effected anyone I've come across is a change in hair colour. Nothing dramatic just a lightening of the hair.
One final comment on this drug, DON’T DRINK. To avoid suffering with the worst hangover on record avoid alcohol while taking this drug. I have had a lot of people contact me concerning this. It seems to be a dehydration issue and a liver problem. As the drug makes you very dehydrated and alcohol does the same thing then its like double dosing! Also your liver is strained with alcohol and also you are only adding to this with alcohol.
I'd also like to take this point in the proceeding to tell you about a message I received from someone on the net about the serious side effects this drug had on her. This is a rare case and I don't want to frighten anyone off taking the drug but I think everyone needs to be aware of all the possible side effects of taking a drug this powerful, its not a drug to be taken lightly.
The following is a summary of the details given and reflects this person's experience only:
Robyn was an extremely healthy, active and energetic person, a member of the New York Road Runners. Two years ago she was prescribed accutane after a visit to Beth Israel Hospital in New York for adult acne. Unfortunately Dr Steven Cohen referred her to the nurse (Goldie Allisandro) who had little experience of the drug and when three days later she started complaining muscle weakness and pains was told that this was a common side effect and that it would go away when the treatment stopped. Shortly after this, her dosage was upped to 80mg from the previous 40mg day. Robyn's muscles started wasting and the pains were like electric shocks as the nerves were damaged. This was after three weeks medication. After many consultant reviews it was confirmed that the accutane had caused this problem and the effects are still with Robyn.
Now that’s not a scare story but I think it does hone in on some important areas. Make sure you see a doctor or consultant who has experience of accutane, so if anything starts to go wrong then you can contact them immediately even if it mean stopping the drug altogether. Listen to your body. You know what is normal for you and what isn't and don't be afraid to tell your doctor. Finally, Remember how powerful this drug is and think about the alternative treatments available and make sure you've tried them first. But, if accutane suits you then it can appear to work wonders for you
