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All Things Accutane

At the request of my dear twitter friend Justmiaiam, this post will cover the good, the bad and the ugly of accutane. Unfortunately its mostly bad and ugly… let’s dive in. Please note, I couldn’t possibly cover all the side effects of this drug, seriously its just that bad.

Accutane is one of 4 brand names for the acne drug generically known as isotretinoin. The remaining 3 brand names are Amnesteem, Claravis and Sotret. So what is it exactly? Accutane is a form of Vitamin A that works by minimizing the amount of natural oil produced by the skin. It is usually prescribed for severe nodular acne after other treatments have proven uneffective. However, a 2 year congressional study found that doctors have prescribed the drug to teens and women with only mild acne symptoms. Accutane is much too powerful for that.

The “bad” side effects:

Some users of Accutane have attributed hair loss (sometimes permanent)to the drug. Because this drug works by altering the oil production and cell regeneration it causes the hair and skin to become extremely dry and fragile which leads to thinning and loss. The hair loss can be anywhere including the eyebrows, eyelashes and scalp. Other users claim that the drug has caused severe back and joint pain that has persisted even after use of the drug has been discontinued. Other “bad” side effects include poor vision, sensitivity to light, dry mucous membranes (nose, lungs, bladder, anus) and depression which could of course lead to more serious problems like psychosis and suicidal thoughts.

Now for the “ugly”:

Accutane has been known to cause severe birth defects and miscarriage. This is more than just a notion. In fact, the warning is so strong that the FDA requires patients to be enrolled in iPledge a program that ensures individuals taking the drug are not pregnant and will not become pregnant while on the drug. The iPledge programs requires that patients must be on (2) forms of birth control and must receive regular pregnancy tests before, during and after treatment as any amount of Accutane (no matter how miniscule) can cause severe birth defects. Common birth defects are of baby’s ears, eyes, face, skull, brain and heart. So why does Accutane effect the reproductive system so severely? The drug contains parabens which demonstrate estrogenic activity, imbalances of human sexual hormones wreak havoc on the reproductive system. Other “ugly” side effects include stroke, seizures, low white blood count (susceptibility to fungal and bacterial infections)and liver damage… just to name a few.

The moral of the story is… while Accutane may prove effective in treating and clearing acne symptoms long term, the side effects are common and far too severe to risk.

Acne: Treating the Culprit

Now that we’ve discussed factors that cause acne, we can explore the treatments. The two most common acne treatments are benzoyl peroxide and salicylic acid.

Benzoyl peroxide works by killing the bacteria that causes acne. This bacteria (Propionibacteria acne)cannot live in an oxygen rich environment. The structure of benzoyl peroxide actually contains 4 Oxygen atoms per molecule (that’s a lot). In essence this ingredient floods the pores with oxygen thereby killing the acne causing bacteria. Benzoyl peroxide also works to keep the pores clear of dead skin cells. Thus, not only does it treat acne, but it helps to prevent future breakouts. This treatment is most effective on mild to moderate acne and can be used with other acne treatments. Because there is no real cure for acne, treatment must be ongoing to ensure clear skin. Benzoyl peroxide is overwhelmingly popular in part because there are no known side effects that come with prolonged use.

Benzoyl peroxide is available in many forms including liquid, cream and bar cleansers, toner, concentrated cream, shaving cream, gel etc. The general consensus is to start treatments in a concentration of 2.5% for at least three weeks and track the results. Benzoyl peroxide is available in stronger concentrations, however, they are a lot more irritating to the skin so the side effects may outweigh the benefits in some situations. The goal is to use the lowest and most effective concentration possible. It is important to note benzoyl peroxide is not to be used as a spot treatment. This ingredient is known to be drying, so it is important to use a good non-comedogenic (doesn’t clog pores) moisturizer. Also, peroxides are bleaching agents so avoid getting them in your hair, or on clothes and towels.

Unlike benzoyl peroxide, salicylic acid does not treat acne bacteria. It is used to treat acne caused by clogged pores that appear in the form of white and blackheads. Salicylic acid is a beta hydroxy acid that sloughs away dead skin cells that could possibly clog the pores. It is able to penetrate the pores keeping them clear and preventing future breakouts.

Salicylic acid is available over the counter in lotion, cream, cleanser, toner, and pre-soaked application pads. Most treatment concentrations range from 0.5% to 2%. Proper use of salicylic acid as an acne treatment would be to start with either the application pads or lotion/cream to get acne under control. Once your skin has cleared it is safe to graduate to a once a week wash or scrub. The use of more than one form of the treatment is highly discouraged as salicylic acid can be very drying and irritating. Similar to benzoyl peroxide, salicylic acid treatments must be ongoing to continue to see positive results. Possible side effects are stinging, burning and excessive dryness. As always be sure to use a good moisturizer.

In the next post of this series will discuss a few less common acne treatments, spot acne treatments and Accutane by request. Until then…

Eeek! Where did this Acne Come From?!

A few of you have asked me beauty questions regarding acne and acne treatments. I like to be thorough with my answers so now is the perfect time for a blog series on acne. We will start with the causes, after all, if you don’t know why it happens how can you treat it?

The source of acne lies far beneath the skin’s surface in the sebaceous hair follicles (also known as pores). The sebaceous glands produce an oil called sebum which is your skin’s natural “moisture” supply. If all goes well then when your skin cells die, they are sloughed off in your sebum supply. Sometimes, things go awry and your skin cells don’t slough evenly. Whatever is left of dead skin cells and bacteria etc gets sticky and clogs the sebaceous hair follicle(s). Overtime, there is a build up of sebum, dead cells and bacteria which presents itself in the form of a pimple or acne. In addition to the gookey stuff, the body will respond by sending an army of white blood cells to fight the bacteria– those get stuck too and while in battle increase pressure in the bump and cause it to hurt. Ultimately the factors that affect acne are your body’s rate of skin cell regeneration and sebum production.

The above is fact. The following is my educated opinion. I welcome my esthy friends to weigh in.

The consensus in the medical/scientific world is that dirt, food and most cosmetics do not cause or even affect the severity of acne. I beg to differ. Keeping in mind that acne is generally caused by dead skin cells and bacteria becoming sticky and clogging the pores, I can’t imagine how dirt wouldn’t get stuck in there too. I have the same theory for makeup that is applied in excess and not properly removed. In regards to food (junk food) our bodies get rid of toxins the best way they know how– secreting toxins through the pores is not a far cry. Consider this: How many of us have been able to smell garlic on a person’s body. I mean, they didn’t even have to speak and you just knew they had Italian food for lunch. Or how about the odor of alcohol radiating off of a person that has had entirely too much to drink… Its seeping out of their pores! My point is– all the chemical preservatives, fat and cholesterol that is ingested from junk food has to get out somehow and the normal exit is not always the most efficient.

So that’s acne in a nutshell. There is no real cure for acne, but there are treatments. Once successfully treated, prevention is key. We will discuss courses of action in the next post of the series.

Until then… Stay Glamorous, acne and all!