Roaccutane: understand how isotretinoin works to fight acne

If you suffer or have suffered, at some stage in your life, with the appearance of pimples, you have certainly heard about Roaccutan® – one of the commercial names of the active ingredient Isotretinoin. This is because the drug is generally considered the most effective treatment in combating acne.

But, it is worth mentioning, the use of Isotretinoin is indicated only in severe cases of acne, and requires medical follow-up, in addition to patient dedication, so that the treatment offers really positive results.

Below you can find all the information about treatment with Roaccutane and can clarify your doubts on the subject.

What is Roaccutane? What are your pointers?

Roaccutane is the trade name of the drug whose active ingredient is Isotretinoin. It is manufactured by Roche laboratory.

“Isotretinoin is a medicinal substance derived from vitamin A, most commonly used for the treatment of severe acne, but it can also be used in the treatment of other dermatological diseases”, explains Elisabete Dobao, a doctor with a postgraduate degree in Dermatology, professor of Dermatology. Santa Casa de Misericórdia do Rio de Janeiro and member of the European Academy of Dermatology.

Isotretinoin is very indicated in severe cases of acne, especially when there is formation of nodules, cysts and abscesses. However, in some cases of moderate acne that does not respond to other treatments, the use of Roaccutane may be indicated.

Elisabete Dobao explains that Isotretinoin can be indicated for both sexes, including adolescents, with an intimate age to be evaluated by the attending physician. The decision to use Isotretinoin should always be taken together with the dermatologist and the patient’s family members when the patient is a minor.

How does isotretinoin work against acne?

Elisabete Dobao explains that Isotretinoin basically acts by reasonably reducing the size of the sebaceous glands and more strongly the amount of oil they produce. “Because acne bacteria live in this oily secretion, their numbers are also greatly reduced,” she says.

“The drug also slows down the production of skin cells inside the pore, preventing them from getting clogged, and has anti-inflammatory properties”, highlights the doctor.

Treatment side effects

“The main side effect and the most feared is teratogenicity (defects in the embryo), hence the prohibition of getting pregnant during and after some time of treatment”, highlights Elisabete Dobao.

According to the doctor, the most common side effects are:

• skin dryness;
• dry eyes;
• dryness of the lips;
• hair loss;
• nose bleed;
• bleeding gums.

Also among the possible side effects, according to doctor Elisabete:

• headaches;
• muscle aches;
• increased liver enzymes and blood lipids;
• depression, among others.

How to deal with side effects?

Elisabete Dobao points out some measures that help a person to deal with the side effects of Isotretinoin:

• Use of a well-established and 100% reliable contraceptive method;
• Use of body, lip and ophthalmic hydration;
• Use of sunscreen.

“All other symptoms will be carefully evaluated by the doctor to define their degree of importance and the need to discontinue treatment”, highlights the dermatologist.

Care during treatment with Roaccutane

Elisabete Dobao highlights that, in the case of women, the main precautions are: having a well-established and 100% effective contraceptive method, in addition to performing monthly serological tests to diagnose a possible pregnancy.

Also according to dermatologist Elisabete, for both women and men, control with blood tests is essential to assess lipid rates, liver tests and blood count, in the period indicated by the doctor accompanying the treatment.

“It is also very important to use body moisturizers, lip balms, eye drops, sun protection and abstinence from alcoholic beverages”, adds the doctor.

Contraindications of isotretinoin

Elisabete Dobao explains that the use of Roaccutane/Isotretinoin is absolutely contraindicated in women who are trying to get pregnant or who are not using 100% effective contraceptive methods.

“It is also contraindicated for patients in whom the complementary exams indicate an inadequacy to the medication”, adds the doctor.

Testimonials from those who have already been treated with Roaccutane

Stephanie Noelle, 24, journalist and blogger for Chez Noelle, was treated with Roaccutane in 2012 for 5 months. “That’s because I have an allergy to salicylic acid and I couldn’t do any more potent treatment with specific acne creams, so my dermatologist suggested the drug. I even took antibiotics too, but I had reactions… So I took Roaccutane when I was 22,” she reports.

For Stephanie, the results were very positive. “Today, it is very difficult for pimples to appear on my face, and the texture of the skin has also improved a lot,” she says.

Regarding the side effects, the journalist says she had dry skin as a whole. “Hair, lips, body, everything became very dry and I had to use a lot of products to relieve the dry feeling,” she says.

“The liver is also very overloaded, so I couldn’t eat fatty foods or fried foods all the time. And when I ate, sometimes I felt sick. But I was very responsible, I did everything the doctor told me to: I didn’t drink, I didn’t leave the house without sunscreen, and I really moisturized my body and face a lot,” says Stephanie.

In the video below, Ana, from the vanite101 Youtube channel, tells why she started taking Roaccutane and her initial experiences with using the drug:

Below, Nina, blogger for Niina Secrets, talks about her experience with Roaccutane:

Can acne come back after treatment?

This is a very common question among people who are about to start treatment with Isotretinoin.

Elisabete Dobao explains that there can be some recurrence (reappearance of a disease or symptom) in up to 30% of cases – and with a higher rate in women who have acne due to an untreated hormonal problem.

Roaccutane vs generics

Another common question concerns the purchase of generic Roaccutane drugs. Are they really effective?

Elisabete Dobao explains that Roaccutane is the reference medication, that is, every generic should normally be compared to it. “But, being a generic medication from a reputable laboratory, with a concern for quality, there are no problems in choosing it”, she highlights.

The price of Roaccutane (20 mg), with 30 capsules, can reach up to 180 reais, depending on the pharmacy where it is purchased. Generics, on the other hand, can be a little more “affordable” (something around 100 reais).

In cases of doubts about which type of medication to buy (the original or generic), the ideal is to talk to your doctor who will guide you on the best choice.

You now have good information about Roaccutane. It is worth remembering that this is a very potent medication, therefore, indicated only in severe cases of acne. Its use should always be indicated by a dermatologist who should also monitor the entire treatment, providing all the necessary information so that the results are, in fact, positive.

Finally, it is worth noting that the success of the treatment also depends on the dedication of the patient, who must strictly follow the guidelines given by his doctor.