Active substances: Isotretinoin
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To start, Accutane was the brand name concocted by Roche Pharmaceuticals for isotretinoin 13-cis retinoic acid, an oral medication that was approved by the FDA in 1982 for the treatment of cystic acne.
Embraced enthusiastically by dermatologists and acne sufferers alike, Accutane—like Band-Aid, Chapstick, and Kleenex—became a proprietary eponym, in which a brand name is so successful, it is used as frequently or more than the generic object it refers to.
It would be twenty years before a generic form of isotretinoin called Amnesteem was approved by the FDA.
And while Roche removed Accutane from the market in, amid increasing allegations of gastrointestinal and psychiatric side effects more on this later, the brand name endures. I took one called Myorisan. To my knowledge, they are all more or less the same, with some manufacturers claiming better absorbency.
Isotretinoin falls under the umbrella of retinoids, synthetic analogs of vitamin A. Like its sister medication, topical tretinoin—also better known by its original brand name, Retin-A—isotretinoin is a first-generation retinoid.
These are the most studied retinoids, with significant research substantiating both their acne fighting and anti-aging properties. I was—and still am—a proponent of topical retinoids, long before I swallowed my first Accutane capsule.
What does Accutane do? These include cells in sebaceous glands, which are the oil- or sebum-producing glands attached to hair follicles that are typically overactive in patients with acne.
Excessive sebum can block the sebaceous gland duct, leading to a closed comedo whitehead or open comedo blackhead.
Then the bacteria Proprionibacterium acnes, which live deep within the follicles, feast on the sebum as their primary food source and overpopulate. Finally, the body responds to this bacterial colonization by releasing pro-inflammatory chemicals, leading to the inflamed lesions characteristic of acne.
These are the classic four factors at the root of acne: 1 increased sebum production, 2 clogged sebaceous glands, 3 P. And while first-line acne medications like benzoyl peroxide, topical retinoids like Retin-A, and oral and topical antibiotics affect one or more of these factors, Accutane affects all of them.
There are several major side effects every Accutane patient should know about, more than a few of which I experienced first-hand. Many groups leave from the Colony Club Aqua School throughout the morning to the location where the turtles swim.
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