Wednesday, April 9, 2014 Article: When Should Accutane Be Considered in Treating Acne?

The following is a preview of an article Dr. Miller wrote for Click here to read the full article.

The traditional treatment of acne usually begins with topical cleansing agents and leave-on gels or creams. If the acne continues to progress and get worse, an oral medication, usually an antibiotic will be added to the topical regimen. Thankfully, most acne is brought under satisfactory control at this point. However, there are a significant number of cases of acne which do not clear. At what point should your dermatologist begin to discuss the controversial acne medication called isotretinoin (better known as “Accutane”)?

What Is Accutane?
There are several brands of Accutane, including Claravis, Absorica, Sotret, Amnesteem and Zenatane. Accutane is a medication that is very closely related to vitamin A. It is believed to decrease the amount of sebum, or oil on the face, causing acne to be significantly less severe. Accutane does have some side effects including dryness of the skin and mucous membranes, joint pains, elevation of triglycerides, suppression of the white blood cell count, and liver enzyme elevations.

The Pros Of Taking Accutane
Treatment of acne with Accutane is performed over the course of 20 weeks. During that time, the acne clears around week 12, and remains clear after the course of treatment for up to several years. This differs from conventional oral antibiotic therapy, which is indefinite in length and can continue for years requiring multiple visits to the dermatologist and usually numerous courses of oral antibiotics. With the controversy surrounding overuse of antibiotics, Accutane provides a distinct advantage. The vast majority of patients taking Accutane suffer nothing more than dry cracked lips and dry skin. Accutane can be taken alone without the need for other oral or topical medications, which makes treatment of acne less complicated.

The Cons Of Taking Accutane
It is well known that Accutane can cause birth defects. Therefore, women who are pregnant or contemplating pregnancy should avoid Accutane. Sexually active female patients of childbearing age should practice two forms of birth control while taking Accutane to prevent accidental pregnancies. It is normally recommended that the pregnancy be terminated if it occurs while the patient was on Accutane. Patients who suffer from chronic depression or have a family history of chronic depression may want to think twice about starting Accutane or be closely monitored for behavior disturbances.

Accutane should be recommended for any patient in which scarring is imminent or already present. For patients without scarring, the decision to start Accutane should be considered when at least one course of oral antibiotics has failed, but certainly after several course of antibiotics have failed. With the controversy surrounding the overuse of oral antibiotics, an argument could be made to start Accutane sooner than later in the course of treatment.

To learn more about Accutane, click here to read the rest of the article. To see if Accutane is right for you, schedule a consultation with one of our dermatologists today by calling (864) 242-5872.

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