Acne and Accutane: Side Effects, Treatment Considerations, and Patient Experiences

Jul 20, 2024

Lecture on Acne and Accutane by Dr. Joyce Park

Introduction

  • Dr. Joyce Park, board-certified dermatologist.
  • Focus on reacting to acne and Accutane related videos and sharing knowledge about Accutane.

What is Accutane?

  • Accutane: Oral vitamin A used for treating severe nodulocystic acne.
  • Not for everyone due to various side effects.

Common Side Effects

  • Dry eyes, lips, and mucous membranes (nosebleeds).
  • Worsening of eczema, dry itchy skin.

Rare Side Effects

  • Mood changes (irritability, exacerbation of depression/anxiety).
  • Bone pain and hair loss.
  • Decrease in ovarian reserve and temporary impact on female fertility.
  • Teratogenic effects: risk of birth defects. Requires monthly pregnancy tests and strict birth control measures.
  • Headaches, decreased night vision, pyogenic granulomas, paronychia.
  • Blood test abnormalities: elevated triglycerides, altered liver function.

Considerations Before Prescribing Accutane

  • Type of acne: reserved for severe, recalcitrant, scarring, painful acne.
  • Moderate acne unresponsive to other treatments may qualify.
  • High risk of permanent scars.
  • Hormonal acne: influenced by androgens, may need ongoing treatment after Accutane.

Hormonal Acne Treatment

  • Various hormonal treatments like spironolactone or birth control.
  • Accutane may improve but not eliminate hormonal acne.

Dosage and Course of Treatment

  • Treatment length: typically 5-7 months, varies by severity and weight.
  • Goal dose determination via weight and clinical response.
  • Adjustments for side effects or lack of response.

Acne Fulminans

  • Explosive, painful acne exacerbation after starting Accutane.
  • Common in severe acne cases, treated by lowering Accutane dose and administering prednisone.

Video Reactions

Video 1: Daisy CBJ’s Transformation

  • Results: Significant reduction in active breakouts and scarring after 6 months.
  • Discussion: Importance of proper dosing and monitoring progression.
  • Note on Acne Fulminans: Risk for severe cases, treated by dosage adjustment and prednisone.

Video 2: Compilation with Nosebleed

  • Explanation: Nosebleeds due to drying effects of Accutane.
  • Remedies: Use of humidifier, Vaseline for nose, and petrolatum for lips. Refresh tears for dry eyes.

Video 3: Multiple Courses of Accutane

  • Recurrence: Up to one-third of patients may need multiple courses.
  • Vitamin A Absorption: Take Accutane with fatty foods for better absorption.

Video 4: Accutane and Nose Shape

  • Debunking Claims: Accutane does not alter nasal cartilage or shape; it only reduces pore size.

Conclusion

  • Overview of Accutane’s effects, indications, and video reactions.
  • Encouragement to leave questions and feedback for future content.

Additional Points

  • Importance of following prescribed guidelines during treatment.
  • Regular follow-ups and blood tests to monitor side effects.
  • Consultation with healthcare providers for personalized treatment strategies.