Acne is difficult to treat and often debilitating disease that affects the skin, usually the face.The most common form is an infection of a hair follicle. This infection causes varying degrees of inflammation, which manifest as pimples, nodules, and cysts.When the inflammation is severe, it can cause permanent damage to the skin and create acne scars.

What is isotretinoin?

Isotretinoin is a type of acne treatment called a retinoid. And first marketed as Accutane by Hoffmann-la-Roche, is a drug primarily used for severe nodular acne. It is a retinoid, meaning it is related to vitamin A and is found in small quantities naturally in the body.

Severe acne can be difficult to treat. When other treatments fail to clear the skin, Isotretinoin may be an option. About 90% of patients see permanently clear skin after one course of treatment with isotretinoin. Unfortunately, Oral Isotretinoin also frequently has significant side effects.

How it works-

Isotretinoin’s exact mechanism of action is unknown, but studies show that isotretinoin induces apoptosis (cell death) in various cells in the body. Cell death may be instigated in the meibomian glands, hypothalamic cells, and hippocampus cells and important for treatment – in sebaceous gland cells.

It works by decreasing the size and activity of sebaceous glands, thus reducing the production of sebum. The reduced production of sebum limits the growth of the bacterium within the follicle. It also prevents the formation of the pore-clogging that creates blackheads and whiteheads.

Common Side Effects-

•  Dry Lips
•  Dry and fragile skin
•  Increased susceptibility to sunburn
•  Minor swelling of the eyelids or lips.
•  Crusty skin
•  Nosebleeds
•  Upset stomach
• Thinning of hair may occur

If any of these side effects persist or worsen, tell your doctor immediately.

Uncommon side effects-

• Back/Joint/Muscle ache/pain
• Headache
• Mood changes
• Tingling feeling in the skin
• Signs of infection(fever, sour throat,)
• Painful swallowing
• Peeling skin on palms/soles.

It may rarely cause disease of the pancreas that may rarely be fatal. Stop taking this medicine and tell your doctor if you develop: severe stomach pain or vomiting.

Stop Taking this medicine and tell your doctor if you develop this unlikely but very serious side effects: a severe headache, vision change, ringing in the ears, hearing loss, chest pain, yellowing eyes, Skin, dark urine.

A very serious allergic reaction to this drug is rare. However, seeks immediate medical attention if you notice any symptoms of a serious reaction.

This is not a complete list of possible side effects .if you notice other effects not listed above.Contact your doctor immediately.Most of the medicines can cause unwanted side-effects although not everyone experiences them.

Precautions –

• This product may contain inactive ingredients (such as Soybean Parabens) which can cause the allergic reaction or other problems. Some people who are allergic to peanuts may also be allergic to soy. Talk to your doctor for more details.
• Before using this medicine tell your doctor about your medical history- especially of diabetes, family or personal history of high blood fat, depression, liver disease, obesity, eating disorder.
• Do not donate blood while you are taking isotretinoin and after one month you stop taking it.
• This medication may make you more sensitive to the sun.avoid sun exposure. Use a sunscreen and wear protective clothing when outdoors.
• Isotretinoin can affect your night vision. Do not drive, use machinery or do any activity that requires clear vision after dark.
• If you wear contact lenses you may not tolerate them. Contact your doctor for more info.
• Do not have the cosmetic procedure like waxing, laser.
• Avoid the use of alcohol while taking this medication because it may increase the risk of certain side effects
• Do not use isotretinoin if you are pregnant, may become pregnant, or if you are planning to become pregnant.
• Since this drug can be absorbed through the skin and lungs and harm an unborn baby.
• You must have two negative pregnancy tests before starting this medication. You must have monthly pregnancy test during medication. If the test is positive, you must stop taking this medication and consult your doctor away.
• It is unknown if this medication passes into breast milk. Consult your doctor before breastfeeding.

Dosage-

• The dosage of isotretinoin depends on the weight and seventy of the condition of a patient. Lower dose treatment, such as 10-20 mg/day (app. half of the high dose), can also be effective, with greatly diminished side effects. Such lower dosage courses may be associated with higher relapse rate, requiring additional courses, especially not taken for enough time.
• Usually, a starting dose of 20mg is taken with the largest meal of the day. After a few months, the dose is increased. If side –effects permit, a higher dose such as 40-60 mg/day can is prescribed.
• In most cases, isotretinoin achieves a complete clearing of acne during a standard dose 12-16 weeks course. Some patients’ acne will need multiple courses of treatments.

Do not allow anyone else to take this medication. It can cause birth defects and other serious health problems.Do not stop, start or change the dosage of any medicine without consulting with your doctor.

According to the survey, it works like wonder for 90% people and 10% might get acne again after 2-3 years but it not as severe as it was.

Do not use this medication without prescription of the dermatologist.

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