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The Good and the Bad of treating Acne

Benefits and potential health risks of isotretinoin

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By Dr. Kaycee Reyes

Acne is one of the most common skin diseases worldwide. It is so common that eight in 10 individuals from ages 11 to 30 years old have had acne at some point in their lives. This is why chances are acne-ridden individuals may have heard of isotretinoin, a potent drug that can singlehandedly stop acne. But while it can be a godsend for some, others are extra-cautious about it. Isotretinoin has been controversial the past years because of its considerable side effects, but it is still the only treatment that can effectively manage acne—a whopping nine out of 10 acne sufferers have seen a drastic difference on their skin. This week, learn about oral isotretinoin, its benefits on the skin and the possible health risks it can bring.

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There are four main causes of acne: overproduction of sebum or oil, skin inflammation, growth of the bacteria propionibacterium acnes, p acnes, and hormonal problems. Anyone can be susceptible to acne, regardless of race or gender, and especially so if family history and environmental factors such as stress, diet, and lifestyle are at play. This is why a lot of acne treatments are available, and what may work for one may not work for the other.

Oral isotretinoin is a medication for those with severe acne, or those whose previous acne treatments have been unsuccessful. A course of treatment runs from four to six months, varying on the dosage (from 10 to 80mg, depending on the patient’s weight) and duration.

This drug, unlike the others, is one to beat because of its high success rate in clearing moderate to severe acne. As much as 85 to 90 percent of patients have seen an improvement in just one course of treatment. Isotretinoin is associated with retinoids or vitamin A, and it works by suppressing oil production, regulating keratin to keep pores from clogging, and reducing inflammation. All these in turn keep the p. acnes bacteria from thriving and causing acne to worsen. Isotretinoin can also treat other skin conditions like hidradenitis suppurativa, rosacea, and even skin aging.

Common side effects are dry skin, lips, and eyes, sun sensitivity, and changes in triglyceride, cholesterol, and liver enzymes levels, all of which are manageable and tolerable. Sounds like a miracle drug? It could be. But there are serious side effects that should not be ignored. Taking oral isotretinoin while pregnant may cause serious birth defects, including major fetal heart or brain abnormalities and an increased risk of miscarriages. Birth defects are serious enough that taking contraceptives and strict guidelines are imposed among patients.

In rare cases, isotretinoin has been linked to inflammatory bowel disease (IBD). It has also been linked to mental health problems such as depression, anxiety, and suicidal thoughts. These serious risks, however, are debatable and no causal relationship has been established to this date. In fact, other studies have suggested otherwise. Still, precautions are necessary and any sudden physical or behavioral changes must be reported to a physician.

The potency of the drug and the serious health risks associated with it are the reasons it is not the primary treatment given to patients. Having said this, with regular blood tests and scheduled visits to the doctor, one should not be afraid of taking isotretinoin. The American Academy of Dermatology stands by the use of isotretinoin of well-informed patients, given that they are guided and monitored closely. If you have persistent acne, deep cysts, and scarring, discuss taking isotretinoin with your physician and do not self-medicate nor purchase from online sellers. When someone has a debilitating skin condition like acne, he would be desperate to find a cure, and isotretinoin may just be one of the major tickets to clear skin.

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