Skin Health Acne Treatment Treating Acne With Prescription Accutane (Isotretinoin) By Angela Palmer facebook Angela Palmer is a licensed esthetician specializing in acne treatment. Learn about our editorial process Angela Palmer Medically reviewed by Medically reviewed by Casey Gallagher, MD on May 20, 2020 Casey Gallagher, MD, is board-certified in dermatology and works as a practicing dermatologist and clinical professor. Learn about our Medical Review Board Casey Gallagher, MD on May 20, 2020 Print Isotretinoin, more commonly known by the former brand name Accutane, is a powerful systemic drug used to treat severe inflammatory acne. Isotretinoin is classified as a retinoid, made from a synthetic form of vitamin A. It is taken orally, in pill form, once or twice daily. stock_colors / Getty Images Accutane has become one of the most effective treatments available for patients with severe or cystic acne, successful even for patients whose acne has not responded to other treatments. According to the American Academy of Dermatology, isotretinoin is considered the most effective prescription treatment available for severe acne. It is generally believed to successfully treat and eliminate severe acne in about half of those who take it. A Last Resort for Severe Acne The decision to begin taking Accutane or another isotretinoin product is something you must discuss with your dermatologist. Because of its potency and possible side effects, the medication is reserved only for those with severe inflammatory or cystic acne that has failed to respond to other treatment options. All patients taking an isotretinoin-based drug are kept under careful monitoring by their doctors. Prior to June 2009 when it was discontinued, isotretinoin was primarily sold as Accutane though it has been available as a generic drug since 2002. Isotretinoin is now sold under the brand names Amnesteem, Claravis, and Sotret. How Isotretinoin Works Isotretinoin works by shrinking the sebaceous glands within the dermis, reducing the amount of oil produced. The exact mechanism of this is still unknown. The reduction of oil within the follicle means less clogging of the pores, leading to a reduction of overall acne breakouts. Common Course of Treatment The most common treatment process consists of a 16- to 20-week course followed by a period of rest. More courses are then prescribed if sufficient clearing is not achieved. For the majority of patients, one course is all that is needed. Approximately 20 percent of patients require a second course. To avoid a relapse, patients must finish the prescribed course, even if the skin becomes clear before all the pills have been taken. During treatment, patients are closely monitored by their doctors. Patients are required to schedule regular follow-up appointments and submit to blood testing to check for possible side effects, such as liver damage and an increase in triglycerides in the blood. Possible Side Effects While isotretinoin is a valuable treatment for those with severe acne, it is not without side effects. The most serious side effects of this drug are miscarriage among pregnant women and severe birth defects in babies whose mothers took the medication while pregnant. The U.S. Food and Drug Administration requires women not be pregnant or become pregnant during isotretinoin use. All women who are of childbearing age are required to take two pregnancy tests prior to beginning isotretinoin treatments. The FDA also requires women to use two forms of birth control for one month prior to treatment, during treatment, and for one month after treatment ends. Women may not breastfeed during this time. Patients who wish to become pregnant after therapy ends should talk to their doctor to determine if it is safe to do so. The other common side effects of isotretinoin use include: Drying of the skin and mucous membranesPeeling of the skinNosebleedsThinning hairSensitivity to the sunDecreased night visionFatigue Patients are warned to contact their doctors if they develop any side effects. Other severe side effects may include: Nausea and vomitingHeadachesBone and joint painDiarrhea or rectal bleedingSevere chest or abdominal painDifficult or painful swallowing. Another possible side effect of isotretinoin therapy is serious changes of mood. The Center for Drug Evaluation and Research division of the FDA warns isotretinoin may cause depression, psychosis, and thoughts of suicide. Any changes in mood should be reported to your doctor. The Bottom Line Isotretinoin has proven to be a successful acne treatment. For those who suffer from severe inflammatory or cystic acne, it may be a viable treatment option, especially if acne has not responded well to other medications. Ultimately, you and your dermatologist must decide if isotretinoin therapy is right for you. Was this page helpful? Thanks for your feedback! Dealing with acne can be frustrating. Our free guide provides expert tips to help you take control. Sign up and get yours today. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. "Accutane." American Osteopathic College of Dermatology. American Academy of Dermatology U.S. Food and Drug Administration