Should My Teen Be on Accutane (Isotretinoin)?
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It's a big deal...
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Severe acne can cause physical and psychological scarring on teens afflicted. There is a stepwise approach to therapy depending on the severity of the condition and what treatments have been utilized in the past by the patient.
Isotretinoin is an oral medication used to treat the most severe form of acne (nodular acne) that is resistant to other forms of treatments including oral antibiotics. Severe nodular acne is when many red, swollen, tender lumps form in the skin. If untreated, nodular acne can lead to permanent scarring. Isotretinoin can cause serious side effects, so when families decide to pursue this treatment it is essential that their physician spend time reviewing important information with them.
The possible side effects of isotretinoin include:
- Birth defects, loss of a baby before birth (miscarriage), death of the baby, or early (premature) births
- Depression and suicidal thoughts
- Pseudotumor cerebri, a condition that causes increased pressure in the brain
- Skin rashes and inflammation
- Intestinal damage
- Elevation of liver enzymes
- Night vision problems
- Elevated lipids (fats and cholesterol) in the blood
- Blood count problems
- Muscle problems
- Growth problems
By the time a patient and their family decides to pursue treatment with isotretinoin, they have tried other treatments for months or years with minimal effect. This decision is not taken lightly by anyone involved, including the patient, family, and the doctor.
In order for a patient to be prescribed isotretinoin, their prescribing physician has to be attested as part of the iPledge Program and the patient has to be registered with the iPledge Program also. This program is designed to prevent pregnancy in all patients who can get pregnant who are prescribed isotretinoin. It is also designed to hold the prescribing physician accountable to counsel and educate the patients and their families on compliance expectations, to monitor side effects closely, and to report pregnancies if one does occur.
All patients who are prescribed isotretinoin must have monthly follow-up visits, lab work, repeated counseling, and close monitoring of side effects. There is a lot of paper work to fill out including a contract.
I am an iPledge attested physician. If your family is a member of Culver Pediatrics Center and would like to learn more about isotretinoin therapy, text us to schedule an appointment. If you are not a member, click here to learn more about our concierge practice or browse through our website for more information.
Resources:
iPledge Program: Committed to Pregnancy Prevention
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