The Health Risks of Accutane

A bad case of acne, especially during the teenage and young adult years, can greatly reduce a young person’s self confidence. No teenager or twenty-something wants to look in the mirror and see a face full of acne lesions. Although there are prescription and non-prescription topical medications that can help in some cases, if acne is severe even these options may have limited benefit. For this reason, many young people turn to the prescription drug Accutane for acne treatment, sometimes even bypassing their doctor and buying it directly over the internet. Unfortunately, the side effects of accutane mean this drug that should only be used under direct medical supervision. What are the risks of accutane use?

What Is Accutane?

Accutane, or isotretinoin, is a compound derived from vitamin A that’s used to treat severe nodular acne. Generally, it’s used as a “last resort” treatment for acne only after topical medications have been used without success. It’s not surprising that this medication has risks and significant side effects since it was originally developed to be used as a cancer chemotherapy medication rather than as an acne treatment. Because it exerts its effects on rapidly dividing cells throughout the body, side effects of accutane can be significant. It appears to exert its action on acne through several mechanisms including decreasing the quantity of sebum produced and reducing the number of comedones or blackheads formed.

Birth Defects

Although highly effective at treating cases of severe acne, one of the most serious side effects of accutane is its effects on the developing fetus which is why pregnancy must be ruled out and contraception used while taking this medication. Most sources recommend using two forms of contraception while on Accutane. Many physicians are even reluctant to prescribe this medication to women of reproductive age because of the high potential for birth defects. Because the risk of serious birth defects, including severe mental retardation, the FDA now requires doctors to sign into a special website and register patients who are taking the drug. Patients who plan on going on accutane must then read and verify that they understand the risks. 

Suicide and Depression

Another risk of accutane is its association with depression and suicide. Patients treated with accutane appear to have a higher risk of depression and some suicides have been reported while taking the drug. Many experts argue that patients with acne are already at a higher risk of depression and suicide because of their condition, so it’s unclear whether the use of accutane is actually the cause. It’s probably not the best choice of medication for anyone with a history of depression.

Other Side Effects

Other risks of accutane include a possible association with the inflammatory bowel disease ulcerative colitis. This disorder has been found to occur at a higher frequency in those treated with accutane, even in the absence of previous intestinal problems. Use of accutane is also known to cause significant drying of the mucous membranes, particularly the throat, nasal passages, and the eyes which can be a source of significant discomfort for some people.

With the risks of accutane use being so serious, it should only be considered in cases of severe, nodular acne that fails to respond to the many topical acne medications available. This is a definitely a medication to treat with respect.