Anti-acne drug that’s derived from vitamin A. This drug works by essentially stopping oil production in sebaceous glands (the oil-producing structures of the skin) and literally shrinking these glands to the size of a baby’s (Source: Dermatology
, 1997; volume 195, Supplemental 1:1–3, pages 38–40). This prevents sebum (oil) from clogging the hair follicle, mixing with dead skin cells, and rupturing the follicle wall to create an environment where the bacterium (Propionibacterium acnes) can thrive, which can result in pimples or cysts. Relatively normal oil production resumes when treatment is completed; although the sebaceous glands may slowly begin to enlarge again, they rarely become as large as they were before treatment. “Because of its relatively rapid onset of action and its high efficacy with reducing more than 90% of the most severe [acne] inflammatory lesions, isotretinoin [Accutane] has a role as an effective treatment in patients with severe acne that is recalcitrant to other therapies” (Source: Journal of the American Academy of Dermatology
, November 2001, Supplemental, pages 188–194).
Isotretinoin is controversial, however, for several reasons, but principally because of its most insidious side effect—it has been proven to cause severe birth defects in nearly 90% of the babies born to women who were pregnant while taking it. Other commonly reported, although temporary, side effects of isotretinoin include dry skin and lips, mild nosebleeds (the inside of your nose can get really dry for the first few days), hair loss, aches and pains, itching, rash, fragile skin, increased sensitivity to the sun, headaches, and peeling palms and hands. More serious, although much less common, side effects include severe headaches, nausea, vomiting, blurred vision, changes in mood, depression, severe stomach pain, diarrhea, decreased night vision, bowel problems, persistent dryness of eyes, calcium deposits in tendons, an increase in cholesterol levels, and yellowing of the skin. However, there is current research indicating that depression does not occur during the course of taking isotretinoin (Sources: Canadian Journal of Clinical Pharmacology, June 2007, pages 277–233; Psychological Reports, December 2006, pages 897–906; European Journal of Dermatology, September–October, 2006, pages 565–571; and Journal of Drugs in Dermatology, May 2006, pages 467–468).