Isotretinoin: Acne Healer Or A Killer

“What has happened to your face? Don't you wash it?”

“You're covered with acne! …”

“Why don't you go to the doctor?

“Only medicine can heal your acne now!”

“Can’t you afford to visit a dermatologist?”

All the above comments reflect overthinking about self-appearance, a loss of self-worth, low confidence, reduced self-esteem, lack of social participation, and isolation from others—all caused by acne. Acne is a skin condition that most teenagers and even adults face once or multiple times in their lifetime. Acne can be caused by various internal or external causes like hormonal changes, excess oil production in the skin, bacterial growth or infection, dietary factors (oily, spicy, high-protein diet, excessive dairy consumption, etc.), genetics, environmental factors (humidity, pollution, hygiene and sanitation), stress, comedogenic skin care products, or certain medications.

Some people claim that acne comes and goes on its own at a particular age. But does it really go away on its own? Well, in my case, I would say “no.” After hearing a lot of suggestions and comments from people, I finally decided to go to a dermatologist. Watching multiple acne-related YouTube videos, TikToks, and skincare reels, and staying indoors wishing for better skin, I did it all. From well-known skin specialists to lesser-known practitioners, I went everywhere, but nothing healed my acne. Finally, the only recommendation I received from a dermatologist was to take “Isotretinoin,” the ultimate acne healer.

Isotretinoin is also known as Accutane. It is classified as a retinoid, a derivative of vitamin A. It is an acne medication that can only be prescribed by a doctor. 

It is an effective medication for many acne patients. When the acne doesn't go away on its own or doesn't respond to any medications or treatments, isotretinoin is finally introduced to patients with severe acne. It cannot be taken by patients without a clinical prescription on their own.

As everything has its good and bad sides, isotretinoin has benefits and side effects too. It works by significantly reducing oil production in the skin and addressing multiple factors that contribute to acne. Isotretinoin makes the oil glands present in the skin smaller, reduces oil production, and stops pores from getting clogged. It changes how the skin cells grow in hair follicles and reduces swelling, which helps to minimise pimples and small bumps.

According to multiple studies, isotretinoin has reduced acne in 80-90 per cent of people. The treatment usually lasts 5 to 8 months but may last longer for some patients, depending on the severity of acne, and the doses vary from patient to patient. Patients with mild to moderate acne are usually given lower doses, and for patients with severe acne, higher doses may be prescribed. The acne might get worse when starting the medication but improves with time.

I was prescribed 20 mg of isotretinoin for seven months by my dermatologist. It reduced my acne over time but also had multiple side effects on my body. I had dry lips and skin, so the skin would peel due to dryness. I had dry eyes, which were reduced with the use of eye drops; occasional nosebleeds; joint and muscle pain; hair fall; continuous headaches; menstrual irregularities; gastrointestinal issues; and mood swings.

Pregnant women are strictly prohibited from taking isotretinoin, as it can cause birth defects in a child. The severe side effects include severe depression, increased suicidal thoughts, triggered anxiety, and mood swings in patients. It can also cause liver damage or abnormalities, darker urine, and excessive abdominal pain. There is a risk of permanent vision loss, too. Some even experience skin blisters and infections. Some people also experience joint pain, bone problems, and fractures. Some report severe cases that include swelling of the face, lips, tongue, and throat. It may also cause difficulty in breathing and severe gastrointestinal issues.

In our society, there are specific beauty standards set for girls, and we often feel pressured to meet them, sometimes even at the cost of our well-being. People with acne face constant remarks about their appearance and are bombarded with various skin advice. Living with acne is a difficult experience. 

While makeup can temporarily conceal acne scars, it’s not a long-term solution, as it isn’t something we can rely on forever.

Isotretinoin should not be taken without a doctor's prescription or under medical supervision. As a patient myself, I accepted all the side effects of healing my acne and getting better skin. Isotretinoin may be known as an "acne healer," but it also carries the label of a "body killer," as we can't unsee its results and side effects.

(Dhungel is a student at St Xavier's College, Maitighar.)