Accutane or isotretinoin is a medication approved in 1982 for severe, nodular and cystic acne. Approximately 20 million people with severe acne have taken this medication and the vast majority have had good success with few problems. In recent years, because of its good track record, it is also being used for many other conditions including folliculitis, rosacea and perioral dermatitis, often in lower doses than for acne.
Accutane is really just high-dose vitamin A, and thus has the same toxicities and potential side effects of having too much vitamin A (hypervitaminosis A). The most important side effect is that it can cause birth defects, so women of childbearing age must take special precautions (e.g. birth control pill) to not get pregnant. The most common side effects are dryness of the skin and mucous membranes, so lots of moisturizer and lip balm during treatment is important. A small number of people will lose a little hair, and others may be achy in the joints if they are very physically active. Rarely, depression and suicide have been reported, though a true link has not been made.
Regular blood tests are necessary to make sure there isn't any adverse effect on the liver or fat levels in the blood, and to ensure a woman isn't pregnant. Despite the long list of potential side effects, the vast majority of people prescribed accutane and monitored by a dermatologist will have few problems.
Dr. Benjamin Barankin is a Toronto dermatologist, practicing medical, surgical and cosmetic dermatology. He is on the executive of the Canadian Dermatology Association, and on the editorial board of numerous dermatologic publications. He is also the author of six books in dermatology, and more than 500 medical publications, and his medical writings are regularly found in the Canadian Family Physician, Journal of Cutaneous Medicine & Surgery, CME Journal and Canadian Journal of Diagnosis among many other journals. He recently opened the Toronto Dermatology Centre with Dr. Anatoli Freiman. This is a state-of-the-art, 6,000 square foot centre providing comprehensive care for the skin, hair and nails for his patients.