Patient Education: Get rid of acne

Sharjah-based dermatologist Dr Minal Patwardhan shines a spotlight on "miracle" drugs and treatments every fortnight.


This fortnight learn about Roaccutane, the magic drug used for treatment of acne and related disorders.

What is Roaccutane?

Roaccutane is a synthetic derivative of Vitamin A. The patent of this process is with Roche Pharmaceuticals for several years. It is standardised and manufactured under a strictly controlled environment.

What is it used for?

It is the wonder drug for acne, acne scars, rosacea, hydranitis suppurativa and diseases related to sebaceous gland disorders.

How does it work?

It causes the entire skin to renew in a way where the acne pigmentation disappears and scars become shallow. In the process it causes a reduction in the size of sebaceous glands and reduces oiliness of the skin. Scalp and hair oiliness is also known to reduce.

How does it differ from Antibiotics?

The treatment is as permanent as you can get. The acne not only clear up but also does not recur for a minimum of three years to a lifetime. Even if it does recur, the acne is so mild that it can be controlled by local applications etc. For this result the patient must complete the treatment and the dose.

What is the dose?

The dose of Roaccutane is calculated according to the weight of the patient and it is administered over six to eight months. It doesn't matter how long you have the medicine or how many tablets are given per day, as long as the dose is completed. The tablets are available as 20mg or 10mg capsules.

Dos and Don'ts

As it is synthetic Vitamin A, additional supplements of high dose Vitamin A are to be avoided. No multivitamin tablets containing Vitamin A, no carrot juice etc. This will avoid Hypervitaminosis A.

Do remember this is a controlled medicine and you must follow-up regularly with your dermatologist.

Prerequisites

This medicine can cause temporary increase in triglyceride and cholesterol levels so a pre-medication blood test is necessary.

Because it is metabolised in the liver, a liver function test is also mandatory.

Pregnancy is a complete contraindication. Patients need to sign a form stating that they will avoid pregnancy at any cost during the course of the treatment and for one month after stopping the treatment.

The synthetic Vitamin A can cause skeletal and skin changes, termed as mutagenic, in the foetus.

This is only during treatment. There will be no side effects during future pregnancies.

Side effects

The commonest side effect is extreme dryness of lips and mucosal surfaces — nose and eyes. Moisturisers can help.

It is important to use a sunscreen, as the skin is prone to tanning.

Contact lenses should be avoided during treatment.

Nasal bleeding or gum bleeding is rare, but might happen.

If itching or eczemas occur as allergic reaction (a common reaction to many drugs) then medicine needs to be stopped.

A very rare side effect is intractable headache and vision disturbances. It is immediately remedied by stopping the medicine.