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Isotretinoin is a prescription used for the treatment of severe acne. This medication decreases facial oil production. High amounts of sebum, can lead to severe acne. If left untreated, severe acne can cause permanent scarring. 

Acne occurs when your hair follicles become plugged with oil and dead skin cells. It frequently causes blackheads, whiteheads, or pimples. It usually appears on the forehead, face, upper back, shoulders, or chest. Acne is furthermost common among teenagers. However, it affects people of all ages. Depending on its severity, acne can cause emotional distress and scar on the skin. The symptoms may be different depending on the severity of your condition:

  • Blackheads (open plugged pores)
  • Pimples (pustules) are papules with pus at their tips
  • Whiteheads (closed plugged pores)
  • Small red, tender bumps (papules)
  • Painful, pus-filled lumps beneath the surface of the skin (cystic lesions)
  • Large, solid, painful lumps beneath the surface of the skin (nodules) 

Seek emergency medical assistance if after using a skin product you experience;

  • Difficulty breathing
  • Faintness
  • The tightness of the throat
  • Swelling of the eyes, lips, face, or tongue 

The Food and Drug Administration (FDA) has already approved this medication. Isotretinoin comes as a capsule for oral use. Each capsule is available in the dosage forms of 10 mg, 20 mg, 30 mg, and 40 mg. 

How does Isotretinoin work?

Isotretinoin is in the group of medications known as retinoids. These are derivatives of vitamin A. When you take Isotretinoin by mouth it works by decreasing the production of the skin’s natural oil or also known as sebum.

You get acne when over-active sebaceous glands in the skin create an unnecessary quantity of sebum. The sebum blocks the sebaceous glands which stop the oil from flowing freely out. It also causes the sebum to build up under the skin. The bacteria linked with acne thrive in these conditions. They feed on the sebum and make waste products and fatty acids that irritate the sebaceous glands. It also makes them inflamed and causing spots. Isotretinoin reduces the size and activity of the sebaceous glands in the skin which reduces the amount of sebum that is produced. This stops the glands from becoming blocked. Wherein, it means bacteria are less likely to thrive. It also decreases the inflammation in the skin.

How long does it take for Isotretinoin to work?

Your acne may get worse when you first start taking Isotretinoin. But, it usually starts to improve within 7 – 10 days of treatment. Most people discover that their acne clears up with a 16 – 24 week of treatment. You’re then likely to remain free of acne for a long time. Repeat courses are not usually recommended unless a definite relapse is seen after treatment is stopped. Repeat courses should not be started until at least 8 weeks after the previous course as your acne may still improve at this time.

How to use Isotretinoin?

The dosage is based on your condition and response to the treatment. This medication is to be taken exactly as it is prescribed by your doctor for the best result. Isotretinoin is usually taken twice a day for 15 to 20 weeks or as directed by your doctor. This drug may be taken with or without food. Take this medication with a full glass of water and do not lie down for at least 10 minutes after taking it.

Swallow the capsule as a whole with a full glass of water. Do not crush, break, or chew it. Be sure to tell your doctor about all the products you use. Do not increase your dose, take this drug more often than prescribed, or stop taking it even for a short time unless directed to do so by your doctor. If you missed a dose, call your doctor right away for instructions. Do not double the dosage to make up for the missed dose. 

What are the side effects of Isotretinoin?

Common side effects:

  • Back pain
  • Joint pain
  • Drowsiness
  • Dizziness
  • Nervousness
  • Cracking or peeling skin
  • Dryness of the mouth, lips, skin, or nose
  • Rash
  • Itching
  • Changes in your fingernails or toenails
  • Crusty skin
  • Swelling of your lips or eyelids
  • Upset stomach
  • Nosebleeds
  • Thinning hair 

Let your doctor know if you have these serious side effects:

  • Tingling feeling in the skin
  • Mental/mood changes
  • Quick or severe sunburn
  • Joint/back/muscle pain 
  • Painful swallowing
  • Signs of infection (persistent sore throat or fever)
  • Peeling skin on palms or soles

Warnings and Precautions 

  • While having this medication, avoid alcoholic beverages. Alcohol could increase the risk of developing liver problems or raised cholesterol levels. 
  • You should not take vitamin A supplements while you’re taking Isotretinoin. This may result in a condition similar to vitamin A overdose which may cause changes in the structure of the bone. 
  • Avoid using other conventional acne treatments including exfoliants, antibiotics, or medicines that loosen the dead skin on the skin surface. However, you can use non-irritant preparations on your skin if needed and it’s fine to use moisturizers. 
  • This medication may make you more sensitive to the sun. Limit your time in the sun. Use sunscreen and wear protective clothing when outside. 
  • Isotretinoin can affect your night vision. You should not drive or use any machinery after dark until you are sure you can do it safely.  
  • Keep this far from direct light or heat and away from the reach of children. 

Isotretinoin is suitable for adults and teenagers. It should not be taken by:

  • Women who are pregnant or breastfeeding. The medication can be harmful to a developing baby and it gets into breast milk can be harmful as well to a nursing baby
  • Children under 12 years of age and children with acne that has developed before reaching puberty
  • People with high levels of fats such as cholesterol or triglycerides in their blood 
  • People with liver problems
  • People with a condition resulting from the excessive consumptions of vitamin A
  • Those who are taking tetracycline-type of antibiotics
  • People who are allergic to any of the ingredients of this drug