Acne, or vulgar acne, is one of the most common skin conditions, especially among adolescents and young adults. Its incidence rate is 60-85%. Despite the abundance of medications, the treatment of acne remains challenging.
Efficacy and safety of systemic retinoids
Systemic retinoids, particularly isotretinoin, are the most effective in treating moderate to severe acne. They are indicated for patients with nodular cystic acne and frequently recurrent inflammatory rashes in whom antibiotics have proven ineffective and for patients with a tendency for acne to resolve as scarring.
Accutane: a new approach to treating acne
Accutane, a drug containing isotretinoin, has been successfully used for several years to treat moderate to severe acne. Accutane uses the proprietary Lidose technology, which increases the dissolved fraction of isotretinoin in the capsule, hence its absorption. This reduces the amount of isotretinoin in each capsule, as the active ingredient is the same as in the original product, and the inactive ingredient is reduced by 50%. As a result, the risk of side effects is reduced.
Side effects of Accutane
Despite its high efficacy, using Accutane can cause several side effects. Most of them disappear within a few weeks of stopping taking the drug. Isotretinoin, the active ingredient in Accutane, can cause dry skin, chapped lips, and dry nasal passages, which can cause nosebleeds. Your skin may become more sensitive to the sun, so sunscreen should be used. Thinning hair is also a possible side effect.
Effects on the reproductive system
Isotretinoin is dangerous to unborn babies. Women of childbearing age should have a pregnancy test before taking this medication. Taking isotretinoin during pregnancy can cause miscarriage, fetal death, or premature birth.
Effects on the central nervous system
Isotretinoin can affect the central nervous system. Some potential side effects include headache and fatigue. Some people have tinnitus or hearing loss. In some cases, hearing loss may become permanent.
Effects on the digestive and excretory systems
Isotretinoin can cause problems throughout the digestive tract. Some side effects include bleeding gums, lack of appetite, heartburn, abdominal pain, bowel pain, dark urine, nausea, vomiting, diarrhea, and rectal bleeding.
High efficacy of Accutane
It should be noted that women with recurrent, resistant to current therapy vulgar acne and hormonal disorders due primarily to hyperandrogenism are recommended to be treated with sex hormones. Taking oral hormones reduces sebum secretion and inhibits the effects of androgens in the sebaceous glands.
Three groups of hormones are used for acne: estrogens, which inhibit ovarian androgens, glucocorticoids, which inhibit adrenal androgens; and oral antiandrogens, which act at the peripheral level. Estrogens in small doses (35-50 mcg) used as oral contraceptives can significantly reduce sebum secretion.
Treatment with anti-androgens is carried out after consultation with a gynecologist and endocrinologist, and the hormonal blood profile (levels of luteinizing hormone, follicle-stimulating hormone, estradiol, progesterone, testosterone, prolactin, and dehydroepiandrosterone), ultrasound of the pelvic and adrenal glands and X-ray/tomography of the skull/brain may be required.
Accutane is a highly effective and safe medication for the treatment of moderate to severe acne. Side effects are insignificant, easily managed, and do not require withdrawal of the drug. Experience has shown that relapses when using isotretinoin occur in the presence of concomitant endocrine diseases and hormonal disorders, so the treatment of acne should be carried out together with other specialists – gynecologists and endocrinologists. Relapses may be caused by prescribing inadequate daily and cumulative doses of the drug and improper dosing regimens.