Accutane is the most well-known brand name of the powerful oral medication derived from vitamin A called isotretinoin.
It is sometimes referred to as the “nuclear option” when it comes to acne treatment because of its ability to provide remission of acne in about 2/3 of people who take a 15-20 week course of the drug, while at the same time causing concerning, potentially lifelong side effects, including severe birth defects.
The FDA has approved isotretinoin only for people with severe, widespread, and scarring acne, but some physicians prescribe it for less severe acne. This is controversial because isotretinoin changes the skin and the body forever. Once you take it, there is no going back. As a real-life example, because of the way isotretinoin can permanently alter eyesight, the U.S. military will not allow anyone who has previously taken isotretinoin to be a fighter pilot.
How It Works: It clears acne primarily through permanently reducing skin oil production, but also prevents clogged pores, reduces inflammation, and reduces bacteria.
Side Effects: Because it is an oral medication, it affects the entire body. Dry, cracked lips and skin are expected, and side effects such as nose bleeds, irritated eyes, rashes, fatigue, headaches, joint pain, and insomnia are just a few of the other common side effects. Concerningly, some of these side effects can be lifelong, leaving the user with, for instance, a lifetime of impaired joints, or the need to use lip balm several times a day for the rest of their life.
Pregnancy: EXTREME CAUTION!: ACCUTANE (ISOTRETINOIN) CAUSES SEVERE BIRTH DEFECTS AND FETAL DEATH. Females using isotretinoin must pass two (2) pregnancy tests before taking isotretinoin, and must use at least two (2) forms of birth control while on isotretinoin.
Suicide & Depression: Many people swear that they are more depressed or suicidal while taking isotretinoin, and while the research we have thus far does not show a connection, anyone taking isotretinoin should closely monitor their mental state.
Take with a High-fat Meal: For isotretinoin to get absorbed into the bloodstream, it should be taken with a high-fat meal (20 grams of fat or more).