Is Accutane Safe?
by Gabe
Mirkin, M.D.
zone3
Isotretinoin, sold under the brand name Accutane, is the only drug that
can cure acne, but it can cause horrible birth defects when taken by
pregnant women. Reports from Britain and Israel show that Accutane
otherwise is much safer than we used to think.
Acne is a condition in which normally colorless, liquid skin oils are
converted to solid white material. Then the skin responds to the trapped
solid oil by turning red and swelling. A three- or four-month course of
Accutane damages the oil glands and markedly reduces the amount of oil
that your skin produces, making Accutane the most effective drug to treat
acne. Having less skin oil should not cause any serious side effects as
its only known function is to keep you from feeling too cold in the
winter, because it slows evaporation of sweat. Dry skin is associated with
lack of water, and aging of skin is associated with lack of collagen, not
with lack of oil.
In the British study, ninety-three per cent of the people taking
Accutane reported no long-term side effects. The British researchers
reported that two percent suffered muscle aches at follow up, and 5
percent suffered from dry mouth. Fewer than one percent claimed that they
had dry eyes and skin and joint pains. Higher doses were not associated
with more side effects. The authors concluded that their study showed that
isotretinoin is a safe drug with no serious long-term side-effects.
However, it causes birth defects when taken during pregnancy.
A study from Israel also shows that Accutane is far safer than many
doctors think. Many doctors refuse to prescribe Accutane for severe acne
because they are afraid that Accutane will damage livers, raise
triglyceride levels and cause heart attacks. In this study, none of the
patients had liver tests that were abnormal enough to stop treatment. Only
1.5 percent of patients had serum triglyceride levels above 400 mg%, but
all continued treatment. Only 3.5 percent of patients required a second
treatment.
I insist that all women who take Accutane do nothing that could cause a
pregnancy while they take it. Three months after stopping Accutane, a
woman has no increased risk for birth defects.
I check liver tests and triglyceride levels and if normal, prescribe 40
mg of Accutane twice a day for 14 weeks. I check liver tests every four
weeks and stop the drug immediately if the liver tests become abnormal. I
repeat liver tests two weeks later, and if normal, restart Accutane.
Eighty-two percent of those who follow this regimen are cured of acne for
life. If the acne returns months or years later, I usually prescribe 40 mg
of Accutane four times a day for one month. Check with your doctor.
ABOUT THE AUTHOR
For Journal references on Accutane see http://www.drmirkin.com/morehealth/G200.htm
Dr. Gabe Mirkin has been a radio talk show host for 25 years and
practicing physician for more than 40 years; he is board certified in four
specialties, including sports medicine. Read or listen to hundreds of his
fitness and health reports here.
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