Accutane: Safe Treatment for Acne?

Most teens or adolescents get acne at some point, but some have worse cases than others. When usual medications or topical treatments don't work, some doctors prescribe Accutane (Isotretinoin). Accutane is a prescription medication for adults and children older than 12 to treat severe forms of acne. It has been known for some severe side effects, so we asked Le Bonheur pharmacist Rebecca Chhim, PharmD, to weigh in. Though are the certain significant risks to be aware of, she assured us that is safe to take.

When should I look into Accutane for my child? Does it work?

Accutane is used for severe acne -- large, painful nodules under the skin, covering a significant portion of the face, back, or other parts of the skin often affected by acne. It does effectively improve severe forms of acne when other medications have not worked. Other acne treatments, such as creams or antibiotics, should be tried before using Accutane. Your child will require close monitoring and enrollment in the iPLEDGE program (discussed below) while on Accutane.

How should you take Accutane?

Accutane is for adults and children 12 years of age and older. It is prescribed for 15 to 20 weeks and should be taken twice a day with meals and a full glass of water. If you miss a dose, skip that dose and take your next dose at the normal time. Let your doctor and your pharmacist know every prescription, over the counter and herbal medication you or your child takes while on Accutane. Some medications and herbals may interact with Accutane. It is important to avoid alcohol and vitamin A supplements while on Accutane.

What are the side effects?

Accutane can cause muscle, joint or bone pain more often in children than in adults. It may also cause eye dryness or vision changes. It is important to avoid driving at night until the full effects on your vision are understood. Accutane has many effects on the skin including skin dryness, rash or extra sensitivity to the sun. For this reason, patients on Accutane should limit sun exposure and wear sunscreen. Accutane could cause hair loss, liver and blood disorders. Accutane is associated with behavior changes, depression and suicidal thoughts. Tell your doctor any behavior changes you may notice in your child while he or she is taking Accutane.

Accutane and Pregnancy Risk
Accutane can be harmful if taken while pregnant. Accutane could cause a loss of pregnancy, premature birth, infant death or infant birth defects if taken while pregnant. The risk of fetal harm is unknown when the partner of a male on Accutane becomes pregnant. For this reason, in order to receive Accutane, every patient, male and female, must register with the national iPLEDGE program. In addition, every doctor who prescribes Accutane and every pharmacy that dispenses Accutane, must also register with iPLEDGE.

iPLEDGE requires very strict rules for women who are able to become pregnant on Accutane, including the use of two forms of contraception while on Accutane, as well as one month before and after taking Accutane. iPLEDGE also requires all patients to see their doctor every 30 days in order to get a new prescription. Women must also take a pregnancy test every month while on Accutane. iPLEDGE has many other regulations in place for patients, doctors and pharmacies in order to avoid pregnancy while on Accutane. The risk of pregnancy while on Accutane must be taken very seriously.