Isotretinoin (Accutane) is a type of acne treatment called a Retinoid. Isotretinoin is available as an oral treatment (Accutane) and as a topical treatment (Isotrex). Oral Isotretinoin is one of the most effective treatments for moderate to severe acne. Unfortunately, oral isotretinoin also frequently has significant side effects.
Isotretinoin works by decreasing the size and activity of sebaceous glands, thus reducing the production of sebum. The reduced production of sebum limits the growth of acne-causing bacteria within the follicle. Isotretinoin also prevents the formation of the pore-clogging plugs that create blackheads and whiteheads.
Oral Isotretinoin has several side effects, which range from mild to severe. Isotretinoin can cause the skin to become very dry and irritated because sebum is necessary to lubricate and protect the skin. The effects of Oral Isotretinoin are semi-permanent, and some patients experience side effects even after they discontinue use of isotretinoin.
Isotretinoin is a powerful teratogen, and the use of Oral Isotretinoin by pregnant women causes severe birth defects. Because of the risk of this side effect, the use of oral isotretinoin is tightly controlled in many countries. Women who are pregnant or may become pregnant should never use isotretinoin.
Oral Isotretinoin has also been associated with an increased risk of depression and suicidal thoughts. However, this relationship is controversial and is not accepted by all experts. Isotretinoin is used primarily for individuals with severe acne, so it is unclear whether the increased risk of depression is caused by the Isotretinoin itself or from the experience of having severe acne symptoms.
Topical Isotretinoin (Isotrex) has a much lower risk of side effects, but it is rarely used to treat acne because newer topical retinoids (eg. Adapalene, Tretinoin) tend to be more effective and produce fewer side effects. Topical Isotretinoin is generally substantially less effective than Oral Isotretinoin for the treatment of moderate to severe acne symptoms (Acne Types: 3-4).