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Basics
Isotretinoin is one of the strongest and most successful medicines available for the treatment of acne. It is indicated for severe acne (nodulocystic types) or for persistent acne that is not responding to other types of therapy. Isotretinoin has received a lot of negative press and several issues are part of the hot topics section. Despite the media frenzy however, isotretinoin remains an extremely helpful medication in the fight against acne and when used correctly can be admininstered with minimal side effects.

How it works
Isotretinoin is a complete medication in that it is the only medication that tackles all of the key factors in acne production. It inhibits oil gland formation hs well as reduces the size of existing
oil glands decreasing the amount of sebum production. In addition is decreases the conversion
of androgen hormones that contribute to further oil production as well as decresing the amount
of androgen hormone receptors. Isotretinoin also normalized they way the skin turns over, decreasing "stickiness," helping the skin to slough more regularly, and helping to make sure
that pores to not get blocked. Finally, isotretinoin is anti-inflammatory as it block certain cells
that contribute to inflammation and pimple formation.

Types of isotretinoin
For many years isotretinoin was available as Accutane. Today, there are several generic equivalents tha exist including Amnesteem and Clarivis.

Potential side effects
There are many potential side effects with isotretinoin. The most severe side effect is birth
defects that can occur when pregnany women take isotretinoin. This is the main reason that isotretinoin is under such strict regulation and why monitoring is so strict during isotretinoin therapy. Women who are pregnany or who are trying to conceive, should not take isotretinoin.

Most commonly, people who take isotretinoin will experience dryness, mostly of the lips and occassionally other area of the body like the tops of the hands. Other potentail side effecs
include increased liver enzymes, increased triglyceridese and cholesterol, muscle aches, headaches, altered vision (particularly night vision), hair loss, and mood swings.

There has been a lot of press regarding isotretinoin and depression. While there have been anecdotal stories of isotretinoin causing severe depression, recent studies indicate that those
on isotretinoin actually are less depressed than those not on isotretinoin. See our hot topics section for more on isotretinoin and depression.

Prior to starting isotretinoin you should make sure that you have a thorough talk with your prescribing physician and that all of your questions are answered. The good news is that despite all of the potential side effects, that aside from some dryness, isotretinoin is usually very well tolerated with excellent results.

Ways of minimizing side effects
The important factor in isotretinoin therapy is achieving a total dose that is based on weight.
How fast that total is achieved is less important. What this means is that by decreasing the
dose and staying on the medicine a bit longer, the same results can be obtained while
minimizing potential side effects.

In addition to this good skin care and the use of moisturizers can help with dryness. Over the counter products like Aquaphor (lips), Ocear Nasal Spray (nose), and eye drops can help fight dryness as well.

 

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