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Treatment of Acne With Isotretinoin - Accutane

How Accutane Works & Starting Therapy

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Updated January 22, 2014

Isotretinoin (Accutane) is a medicine that revolutionized the treatment of acne. Accutane belongs to the family of medicines called retinoids, which are similar to vitamin A. Accutane, like other retinoids, works by altering DNA transcription. This affect decreases the size and output of sebaceous glands. It also makes the cells that are sloughed off into the sebaceous glands less sticky, and therefore less able to form blackheads and whiteheads (comedones). It also reduces the number of bacteria in the sebaceous gland and on the skin surface.

Who Takes Accutane?
Accutane is generally used for nodular, pustular acne that has not responded to full courses of several oral antibiotics. The trend in Accutane prescribing for acne has been towards using it earlier in the course of the disease, especially if there is significant scarring. While Accutane is used primarily for severe acne, it has also been used for other disorders such as psoriasis, lupus, and lichen planus, with varying degrees of success.

Starting Therapy With Accutane
Several dosing regimens are used, but the most common regimen involves starting with a low dose, then increasing the dose after several weeks. The length of the treatment course varies but generally lasts from 16 to 20 weeks. Some people notice that their acne gets worse after starting Accutane therapy. The number of acne lesions usually does not increase; rather the lesions may become redder or more painful. This is normal, lasts only a short while, and is not a reason to stop using Accutane.

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