Roaccutane (isotretinoin) is a medication which can only be prescribed by a doctor. It’s a synthetic derivative of vitamin A used to help tackle moderate to severe acne.

The use of Roaccutane must be monitored closely by a doctor, and it is prescribed in courses; usually between four and six months.

It takes time for teenagers with acne to begin responding to the medication and often acne will get worse before it gets better, so it’s important to follow Dr. Fay’s instructions on taking the medication for the prescribed duration.

It can have potentially serious side effects, and as it is often used for teenage acne, parents must be made aware of this.

Roaccutane works by:

• Reducing the production of skin oils or ‘sebum’ by up to 90%, although once you stop taking it the sebum levels return to normal.
• The bacteria that causes acne, called propionobacterium acnes (or P. acnes for short) at the surface of the skin is targeted by Roaccutane. So is the ‘pilosebaceous unit’ or hair follicle under the skin.
• It reduces the plugging and clogging of the pore.
• It reduces inflammation within the pilosebaceous gland.
• It reduces the amount of dead skin cells that clump up with skin oil to block the pores.

When is Roaccutane used?

It’s used to treat acne that won’t respond to any other therapies. It’s also used for severe nodulocystic acne, as this type causes scarring and hyperpigmentation marks if left untreated.

It can sometimes be used for other conditions like rosacea, but Dr. Fay will need to evaluate each patient individually, taking into account their history and other medications they may be taking.

Acne worse before it gets better

As Roaccutane can appear to make acne worse at first, Dr. Fay can put you on a course of an oral steroids in the initial few weeks to help counteract the inflammation if needed.

90% of patients see a dramatic improvement in their acne within 4-6 months of treatment.

Side Effects of Roaccutane: Common and Rare

The following are some of the more common side effects of Roaccutane, and if Dr. Fay feels you would benefit from taking it she will go through the details very carefully with you.

Common side effects

• Initial dryness of the skin, eyes and lips are very common when you first begin to take Roaccutane but tend to get better as your tolerance increases.
• You must be careful to use only an approved skin care regime whilst you’re taking it as your skin will be quite delicate, and a sunscreen is always recommended. You shouldn’t have any other facial therapy or exposure to sunlight whilst on the drug, and not for up to six months afterwards depending on the advice of Dr. Fay.
• Skin and mucous membranes – the lining of your throat, nose and your eyes – get very dry. This leads to an increased risk of skin infection and tonsillitis, you may experience nosebleeds, or find it hard to wear contact lenses.
• Muscle and joint aches may occur after exercise.
• Temporary thinning of the hair, or telogen effluvium, may occur.
• Roaccutane can also impact night vision as it alters levels of Vitamin A, so should be used with caution by anyone who needs good night vision for their work or driving.

Dr. Fay will request a blood test once a month before reissuing your Roaccutane prescription – it can inflame the liver and increase fat levels in the blood, so lipid levels need to be checked. For this reason it’s not recommended that you drink alcohol whilst taking it.

Rare side effects of Roaccutane

These are the ones you read about in the media, which cause some sensationalist headlines. A number of more serious side effects have been reported, although they are very rare.

• There have been reports of mood change and depression and even suicidal thoughts. For this reason it is very important to discuss your family history including any mental health problems with Dr. Fay before starting Roaccutane.
• Rarely inflammation of the liver or pancreas may occur, and even more rarely benign intracranial hypertension, so if you start developing severe early morning headaches see your doctor immediately.
• Roaccutane must not be taking whilst pregnant or breastfeeding, or if you are attempting to conceive.

For further information or to book and appointment at the acne clinic at Cosmetic Doctor,
call 01 685 3100.