Accutane Side Effects – The Other Side Of The Story

By Seppo | Acne drugs

19

Accutane is to the holistic acne treatment folk what Monsanto is the organic folk: pure unadulterated evil that can do no good. The drug is universally demonized in the natural health community, and hot on the heels are lawyers eager to scare people into signing up for a class action law suits.

It is said that truth is the first casualty in every war. It’s certainly true in the war the natural health folk and lawyers have declared on Accutane. In the midst of all the fear-mongering, nobody presents rational, balanced and science-based discussion of the risks and benefits of Accutane. So I took it upon myself do just that.

I knew I had to write this post when a reader posted the following comment on another post where I talked about a study showing new side effects from Accutane.

Naturally Clear Skin Without The Confusion And Stress

Zen of Clear Skin shows how to liberate yourself from acne - and the stress of trying to get over it.
FREE Download
zen-cover-350
Zen of Clear Skin

Here’s the comment she posted.

Hi! :) i read your acne history and noticed that you have taken accutane. I have a couple of questions on my mind and hopefully you have time to answer, i’d really appreciate it because I too have taken accutane and now i’m kinda scared of having done damage to my body. How old were you when you took accutane and how old are you now? Have you been healthy since taking it? based on your knowledge, do you think that accutane can cause any kind of long term damage or premature aging?( there are so many people on the internet speculating that) and don’t all medications cause at least some oxidative stress? and have you run into any studies about if accutane inhibits cellular proliferation even after discontinuation of treatment? and does accutane really destroy water holding molecules in the body?

I’m going to answer all the questions she asked, but before that I want to put all the Accutane injury stories and fear-mongering into perspective.

Are Accutane injury stories the result of a logical fallacy?

If you’ve researched Accutane you’ve no doubt read stories of people claiming to be injured by Accutane. I suggest you take them with a grain of salt. Here’s why.

We humans have a strong need to make sense and feel in control of our lives. We absolutely abhor the notion we are not in control. So when something bad happens, we demand to know how and why it happened. We need to know the cause and who to blame. We demand to be in control, even if it’s only illusionary.

But nature is inherently random. When a predator kills a prey, there’s no grand design or intention involved. The predator was hungry and the prey was in the wrong place in the wrong time. Virus infecting a person is not driven by a grand design, it merely exploits an opportunity.

People born with genetic abnormalities do so because of randomness inherent in multiplication of genes. Those mutations drive the evolution of all life on earth. Some mutations are beneficial, the vast majority are not. It sucks to be born with harmful mutations, but since life itself depends on mutations, the process goes on. Nature is a cruel mistress, indifferent to the plights of any individual.

This inherent randomness in life doesn’t play well with our need to understand and be in control. Interesting side note: pretty much the entire alternative medicine field is built on peddling the illusion that we have more control over our health than we actually do.

We frequently torture logic and reason while trying to make sense of the world. One of the most common logical fallacies we commit is the post hoc, ergo propter hoc (Latin: “after this, therefore because of this”) fallacy. When B happens after A, we assume that A causes B – simply because it happened after A.

The entire vaccines cause autism fallacy is based on this loopy logic. Parents start to notice the first signs of autism at around 18 to 24 months, which is just a few months after some vaccinations. Aided by ‘education’ from the university of Google, some parents mistakenly conclude that the vaccine caused autism. I say mistakenly because studies have clearly shown no connection between vaccines and autism. Furthermore, studies have shown signs of autism already much earlier, even in the womb. These signs are just too subtle for parents to notice.

My point is that just because some people noticed some health problems following Accutane treatment doesn’t mean Accutane caused those problems. Millions of people experience unexplained health problems every day. Millions of people take Accutane every year. Purely by coincidence there are going to be people who experience unexplained health problems shortly after taking Accutane.

I want to make it clear that I’m NOT saying this explains every story out there. I’m sure some people have really been injured by the drug. But just because someone claims to be injured by Accutane doesn’t mean he or she is right.

Putting side effects into perspective

accutane-side-effects

Accutane is a powerful drug that causes side effects, in some cases severe ones.

Because of the potential for harm, there’s an ongoing effort to better understand and minimize the side effects. In 2013 alone 53 scientific papers were published that talked about the adverse effects of isotretinoin (the generic name for Accutane).

By all reliable accounts severe side effects are very rare.

Dr. Marius Rademaker reviewed patient records of 1743 people treated with Accutane. About 81% of the patients reported side effects. However, the vast majority of these were mild (70.1%) or moderate (9.8%). Only 3 patients (0.17%) reported severe side effects, 2 of which were birth control pill failures. Side effects were dose-dependent, so those who got a lower dose reported fewer and milder side effects.

Accutane and gastrointestinal damage

Many people claim Accutane causes intestinal damage, some people apparently had to have their colons surgically removed after treatment. Dr. Raed O. Alhusayen and colleagues compared the rates of inflammatory bowel disease (IBD) between people treated with Accutane, topical acne medications, and general population. Their analysis included data from 46,992 people treated with Accutane, 184,825 people treated with topical acne medications and 1,526,946 untreated individuals.

They showed that Accutane did not increase the risk of IBD. Among people diagnosed with IBD, taking Accutane did not increase the risk of hospitalization (due to aggravation of IBD). In other words, this massive study showed no connection between IBD and Accutane. The study did show a possible connection between IBD and acne itself. I’ve covered the link between gut problems and acne extensively in other posts.

Does Accutane cause depression and suicides?

Some people claim Accutane causes depression and increases the risk of suicides. That data on this point is not as clear as for IBD. While most studies show treatment with Accutane does not cause depression or suicides, we can’t yet rule out the possibility.

Regardless, the possible increase in risk seems small. A Swedish study showed 1 additional suicide attempt for every 2300 new 6-month Accutane treatments, that’s 0.04%.

Man boobs, blindness, and kidney injury: reports of serious problems

Rare as they may be, serious side effects can and do occur. Here are a few case studies published in the recent years. A 17-year old girl developed an acute kidney injury after Accutane treatment. Fortunately, her kidney function recovered in 5 weeks after stopping the treatment.

Another case report talks of a 19-year old woman who started bleeding on her left eye and consequently lost vision on that eye. I don’t have access to the full-text of that case report and can’t say whether her vision recovered or not.

Yet another report talks about a 20-year old male who developed gynecomastia (man boobs) after taking Accutane.

Update: Sexual dysfunction as grossly under reported side effect?

I’ve recently learned that erectile dysfunction, vaginal dryness and other sexual side effects may be grossly under reported. None of the reviews I read made any mention of these. However, Mexican researchers published a paper in 2005 that showed 6 out of 20 men suffered erection problems as a result of taking Accutane. Whereas only 2 out of 35 people taking minocycline (control group) reported erection problems. Accutane increase the risk of erectile problems by whopping 600%.

If true, these are very alarming results! It’s nothing short of an outrage that in 9 years nobody has followed this up with another study. Because this is the only study looking at this, it’s impossible to say how common these side effects are. What I can say is that you can find hundreds of men who complain about this online.

In the Mexican study the symptoms faded over time and all the men were able to have and sustain normal erection. But not everyone may be so lucky. There are reports of men complaining that the problems have persisted for years.

Life permanently ruined by Accutane

Just to make it clear that Accutane does sometimes cause extremely severe and permanent side effects, I’m going to share with you one such experience. This was sent to me by a reader and I’ll keep it anonymous.

“I suffered from acne since i was a teenager. At first it was quite mild but later became severe to the point where i had multiple cysts on my back and face. Topical treatments didn’t work so when i became 18 and was about to go to college my doc decided that accutane would be the solution so i started my 1st accutane course. This is where the first side effects manifested. During the first days of my course i experienced a terrible acne breakout which left many scars. It was so serious that i decided to stop the treatment after only 15 days. This was the only side effect i got but acne didn’t clear up as 15 days was not long enough to clear my serious acne.

The nightmare starts

4 years later and as my acne didn’t get any better i decided to give accutane a 2nd try.This time no initial breakout occurred and i thought that everything would be fine and my acne nightmare would finally come to an end.I was so wrong.During my 2 month treatment i experienced some serious side effects which i though would go away after treatment stopped.

Vision ruined by retinal detachment

My first side effect was that i started not being able to see at night with my left eye.I though it was because of the night vision impairment that accutane is well known to cause. Later during the course i noticed that my daytime vision in my left eye also deteriorated so i decided to visit an ophthalmologist. I was devastated when he told me that in my left eye the retina had been detached! This meant that my vision deterioration was not due to the cause i though it was previously. I had a surgery immediately the next day after the diagnose in order not to lose any more vision. My vision acuity in my left eye never returned to normal levels. Not only did accutane cause a permanent impairment in my vision but i was surprised when i found out that my myopia increased by 2 diopters in both eyes!

Libido ruined

Unfortunately this was not the only side effect i experienced. I noticed during my course that my libido dropped significantly. Also the sexual sensation on my genitals pretty much disappeared. Again i though that such side effect would be temporary as it was not even stated in the drug leaflet! 6 years have passed since then and my libido hasn’t come back. Not only that but it has actually gotten worse. Moreover i have developed erectile dysfunction and anorgasmia because of the fact that i can no longer get sexually aroused.

Aggression and rage

Another permanent side effect that experienced was extreme aggression and constant rage. I managed to get rid of this side effect by taking antipsychotics for a while.

The drug has permanently affected my life resulting in a severe degradation of my quality of life. The permanent side effects make it difficult for me to develop relationships with the opposite sex. In general i enjoy life a lot less and the psychological negative impact of the side effects has been furthermore disabling.”

Side effects like these are rare, but I wanted to share with you this story just so you understand they can and do happen occasionally.

Medicine is always a risk vs. benefit calculation

There are no 100% safe medications. Anything that has a potential to do good also has the potential to do harm. Think about it, in order to have a positive effect a medication has to affect the biochemistry in your body. And there’s no way to exactly predict what happens when you mess up with the biochemistry.

Think of the biochemistry in the body as a huge tangle of yarn. Your goal is to move a specific end of a yarn by pulling at another yarn at the opposite side. Do you think it’s possible to move just one piece of yarn? Of course not. The moment you pull at one yarn you are going to move several other yarns. That’s not unlikely how the biochemistry in your body works.

This applies equally to natural (herbs and supplements) and prescription drugs.

All medication is inevitably a decision to balance risks and benefits.

From what I’ve read, it seems that Accutane is about 85% effective against acne. That is, 85% of the patients get very good results. Is that enough to justify the severe but rare side effects? That I can’t answer for you. I can only report the facts, but the ultimate decision rests on you.

Scaring people is easy, informing less so

Scaring people is very easy. Just about every day some scientifically illiterate food blogger spreads unfounded fears of common foods. Fear is a powerful emotion and once that seed is planted, it’s difficult to get out. Studies show facts linked to fear are remembered much better than other facts.

Stories that evoke fear and anger are also great for social media. They get shared like candy. By contrast science-based and balanced discussion is bland, easily forgotten, and left unshared.

So had I been social media savvy, I would have titled this post something like this: “Accutane robs sight from 19-year old, sweet girl – also causes man boobs and kidney damage”. Technically I would have been correct. With an alarming headline like that, this post would have been shared widely in the social media and alternative medicine sites.

It’s easy to twist facts to support your bias when you can forget pesky things like truth and balance.

But I don’t think such a post would have helped you. I don’t think Accutane is the right choice for most people, and I think there are better ways to get over acne. But regardless of what I think about Accutane, you have the right to decide what’s the right choice for you. And you need honest, unbiased information to do that.

My point is that all the fear-laden blog posts and Accutane injury reports tell more about the nature of humans than about Accutane itself. They represent the 0.2% of cases as if they are what happens to the majority.

With the self-righteous navel-gazing out of the way, let’s go through the questions.

Accutane questions answered

I too have taken accutane and now i’m kinda scared of having done damage to my body

Well, is there something wrong with you? Have you been diagnosed with something? If not, you might want to read this: Cyberchondria: How the Internet Is Making Us Paranoid About Health.

How old were you when you took accutane and how old are you now? Have you been healthy since taking it?

If I recall correctly, I was around 18 or 19 when I took it. I’m 36 now. As far as I can tell, it hasn’t caused any long-term health problems for me. While on Accutane, I got the usual side effects; very dry skin, dry eyes, chapped lips, etc. Nothing that would have troubled me too much.

based on your knowledge, do you think that accutane can cause any kind of long term damage

Yes, it’s possible. As I discussed above, Accutane can cause severe side effects. Fortunately, these are very rare and usually go away once you stop taking the drug. But it’s possible for Accutane to cause long-term side effects.

or premature aging?( there are so many people on the internet speculating that)

Most people who take Accutane get dry skin, but I’m not sure I would call that premature aging. You also have to keep in mind that acne itself can cause long-term scarring and skin damage.

The choice is not between skin damage from Accutane and perfect skin. The choice is between possible skin damage from Accutane and the very real possibility of scarring from acne.

and don’t all medications cause at least some oxidative stress?

No.

have you run into any studies about if accutane inhibits cellular proliferation even after discontinuation of treatment?

The fact that Accutane is a permanent cure for many people is proof that it reduces cellular proliferation even after the treatment ends. One reason people get acne is because the sebum and keratin producing cells proliferate (multiply) too rapidly.

Your question implies that inhibiting cellular proliferation is a bad thing. In some cases it is bad, but there are also cases where you need to inhibit it. Cancer is a good example. Cancer is a form of uncontrolled cell proliferation.

and does accutane really destroy water holding molecules in the body?

Sometimes Accutane fear-mongering goes beyond silly. This is one such example. If this were true, then people taking Accutane would die of dehydration. With millions of prescriptions filled, I think someone would have noticed :)

Conclusion

The ability to make an informed decisions requires access to all the pertinent facts. The crunchy holistic health folk would have you believe that taking by Accutane you are poisoning yourself. This is nothing short of blatant fear-mongering and distortion of facts.

Accutane is a powerful drug and nearly everyone who takes it experiences some side effects. For the vast majority these amount to nothing more than dry skin and chapped lips. But there are unlucky few, and we are talking about 1 in 1,000 to 1 in 10,000, who experience something worse. However, even most of the severe side effects resolve once the drug is stopped. The really few unlucky ones can suffer severe, permanent damage from Accutane.

All medication means balancing risks against benefits, and you have to decide if the benefits of Accutane are worth taking the risks.

Don’t Know How To Get Over Acne? Let Me Help!

Acne doesn’t have to be confusing or complicated. I can promise that in 10 minutes (the time it takes you to read the next 2 articles) acne finally starts making sense - and you know how to boot it out of your life.

Click here to get started

Follow

About the Author

Seppo Puusa, a.k.a. AcneEinstein shares rational advice about natural and alternative acne treatments. Read more about me and my acne struggles at the page.

Leave a Comment:

(19) comments

Diane February 18, 2014

A well written article and much to consider. However if anyone is considering taking Accutane I would urge them to try something else. My son used it at 16 and then a short second round at 17 and has developed many many side effects. He is now 22 and diagnosed with IBS and fibromyalgia. Would those have happened without the Accutane ? We don’t know for sure, but we don’t think so. And we wish we didn’t even have to wonder. It was not worth the untold doctors, tests, and pain he had gone through!

Reply
    Seppo February 18, 2014

    Thanks for sharing your family’s experience with Accutane, and I’m sorry to hear about your son. It’s impossible to say whether those would have happened without Accutane. Research suggests that there’s a link between acne and gut problems. While not diagnosed, I’m pretty sure I also have IBS (luckily fairly mild). Anyway, even if research doesn’t support the link between Accutane and some health problems, we are all different and it’s impossible to say how any one individuals reacts to a powerful drug like Accutane.

    I agree with you that one should be careful with it, and I would consider it as the absolute last option.

    I hope your son gets better, or at least learns to live with the problems.

    Reply
Renata February 22, 2014

Hi Seppo,

That’s a nice eyes-opening article. I was wondering from your own experience, whether the oiliness of the skin has decreased permanently after the treatment? And did the oiliness of the scalp has decreased too?

Many thanks,

Renata

Reply
    Seppo February 24, 2014

    I can’t really say. My skin is quite oily now, but that could be because of the hot and humid climate of Thailand. Ambient conditions can have a big impact on how much oil skin produces. It’s so long since I’ve been in a cooler climate that I can’t say how my skin would react there.

    Reply
Ronnie February 27, 2014

Wow this was a good unbiased article and good on you for providing that link to the “cyberchondria” article! I too, have taken accutane but since I didn’t take it until I was like 27 I have a different perspective on it than a lot of its crybaby users. I had inflammatory acne all through my 20’s and it just got progressively worse and worse no matter what kind of dietary and skincare changes I made (and I tried it all!). Yes, certain foods like sugar and dairy can worsen my acne but guess what? Accutane has nothing to do with that and knowing my dietary habits worsened my acne did NOT solve the problem for me! None of that knowledge made a difference until I was able to get clear with accutane.

I was so afraid of accutane that I waited until I was suffering so much to finally take the plunge and take it–and then when I did finally take it I made myself so scared of it with my internet research that I only agreed to take it low dose and actually stopped after only 3 months the first time (I got myself so worked up about it that I bailed out of it).

It makes me so sad now when I think of all that suffering I went through bc when I took it for reals (like a full course at a full dose) half a year later it worked like a charm and I suffered no ill effects! Don’t believe the hype people! Apparently, if you have a life and aren’t sitting around obsessing about your skin and meds all you will suffer from accutane is dehydration and dry lips–and flushing (tons of flushing). I used moisturizer and my skin did not even flake (clear as a bell the entire time too). It might not be a cure but it allows you to basically hit the reset button so you can get it under control.

Btw my skin is still oily and I still break out but I’ve learned to stay away from prescription meds bc when I tried to go back to retin a what do you know I started to break out just like before! Cleansing with Hibiclens and toning with Epsom salt of all things keeps it under control.

Reply
    Seppo February 27, 2014

    Thanks for sharing your experience, Ronnie. The net is so saturated with Accutane fear-mongering that it’s easy to forget nothing bad happens to most people who take the drug. Google search gives you the impression that just about everyone who takes the drug suffers some horrible side effects. Science shows this is clearly not the case.

    Let’s hope this post and your comment gives some balance to the discussion. Though, I’m afraid this post will just drown in the sea of nonsense in Google results.

    Reply
Maria March 4, 2014

Hi Seppo, thanks for writing such a thorough answer, it was very helpful. After going through several courses of antibiotics and topical treatments, i spent a couple of years trying to heal my acne naturally, mainly through diet choices and i just wasn’t getting any results, couldn’t put all the pieces together on my own despite all the effort, and dermatologists couldn’t give any helpful information on the effects of diet on acne, so then i finally went on accutane, but my acne returned 6 months after discontinuation of the drug. It actually made things a bit worse for me, because now i have both very dry skin and acne. Overall i feel like my skin is very different now than before taking accutane, especially the skin under my eyes , i’ve developed some fine lines although although i’m only 20, that’s why i asked about the premature aging and if you knew anything about it.

Also the studies about accutane causing oxidative damage to DNA worry me, for example this one http://www.ncbi.nlm.nih.gov/pubmed/16232082 and the two studies you posted about. it’s hard to say how extensive the damage is though, and if it is repaired over time. but from what i’ve understood, oxidative damage to DNA is what causes aging and age related illnesses, and this is why antioxidants are good for you, although a certain level of oxidative stress is necessary, and it is a part of the immune response, and oxidative stress is necessary for example in the body’s fight against cancerous cells. it seems like a very complicated matter so i actually asked a very good doctor about this matter, and what i got out of his explanation was that since i’m still so young, my body repairs oxidative damage fast and effectively, and his general opinion was that accutane is safe. he also explained to me that it is very common that a drug’s complete mechanism of action is not known, and it doesn’t mean the drug is dangerous.

I wonder if you ever ran into this guys website http://www.aquatic-ape-diet.com/blog/hoffmann-la-roche’s-cover-up-of-accutane/ , I was wondering what you would make of his claims. he presents an opinion that based on what he’s read, he has discovered the mechanism of action of accutane, he claims it causes telomere shortening and is a lethal scam by the reedy drug companies.

Reply
    Seppo March 5, 2014

    Overall i feel like my skin is very different now than before taking accutane, especially the skin under my eyes , i’ve developed some fine lines although although i’m only 20, that’s why i asked about the premature aging and if you knew anything about it.

    OK, this makes more sense. When you put it like that I agree that it’s possible for Accutane to cause premature aging. The oil the skin produces retains moisture and protects the skin. So drastically reducing the amount of oil on the skin can have a negative effect.

    A good skincare routine should be able to minimize and to some degree reverse the harm from Accutane. I would recommend some antioxidant moisturizer twice a day and a retinol cream in the evenings. Retinol reduces the signs of aging, like fine lines, and antioxidant moisturizer rebuilds and protects the skin barrier.

    Repairing the skin barrier should help with acne also. Bad skin barrier allows stuff that shouldn’t get to the skin get in. This can make you more acne prone.

    I don’t know what to make of the studies showing DNA damage. On the face of it, it sounds worrying. But we are exposed to DNA damage every single minute and the body has a good way to repair the damage. Though sometimes the process doesn’t work as well as it should and this can lead to cancer.

    There’s pretty good safety data for Accutane already. I mean it has been used for several decades already and I’ve never seen any research that would show it causes significant harm (other than in rare cases). That said, I don’t know how many large and really long-term studies have been done. There’s always the possibility that the scientists just haven’t asked the right questions and thus have missed something.

    but from what i’ve understood, oxidative damage to DNA is what causes aging and age related illnesses, and this is why antioxidants are good for you, although a certain level of oxidative stress is necessary, and it is a part of the immune response, and oxidative stress is necessary for example in the body’s fight against cancerous cells.

    That’s the narrative media and alt-med proponents push. That oxidative stress is damage in the body and limiting that damage with antioxidants can prevent disease and slow down aging.

    Unfortunately, I don’t think it’s that simple. While antioxidants seems like a plausible treatment for many health problems, many of the human studies have been negative (that is, antioxidants don’t work).

    I don’t think we yet completely understand the dynamics of oxidation and antioxidants in the body. Science-Based Medicine blog has a few good articles on this. I recommend you check out these:

    http://www.sciencebasedmedicine.org/antioxidant-hype-and-reality/

    http://www.sciencebasedmedicine.org/are-berries-the-new-snake-oil/

    http://www.sciencebasedmedicine.org/inflammation-both-friend-and-foe/

    I wonder if you ever ran into this guys website http://www.aquatic-ape-diet.com/blog/hoffmann-la-roche’s-cover-up-of-accutane/ , I was wondering what you would make of his claims. he presents an opinion that based on what he’s read, he has discovered the mechanism of action of accutane, he claims it causes telomere shortening and is a lethal scam by the reedy drug companies.

    Sorry, too long, didn’t read. I did scan it through and seems like many of the points were linked to Accutane litigation and made by lawyers. It’s true that Roche has paid untold millions to Accutane victims, but this doesn’t necessarily mean Accutane really caused that damage. Science is not settled in courtrooms.

    I find it very hard to believe that an individual blogger, with apparently no scientific training, would have discovered a mechanism of action that’s missed by scientists actually doing the research. It’s not impossible but I find it extremely hard to believe.

    Alties and natural health proponents like to always bring up the big pharma conspiracy. That we are somehow murdered or poisoned by the drug companies. That argument is just beyond silly to me. There’s plenty of research that’s done independent of the drug companies.

    The big pharma conspiracy argument assumes that all the scientists with no real connection to drug companies would either be too stupid to notice this conspiracy or would go along with it (with no real benefit to themselves). Yet, somehow these scientifically illiterate natural health gurus have uncovered this conspiracy.

    I’m not claiming that drug companies are saints or act in the interest of humanity. They are driven by profits and it’s well known they do shady things to improve profits. The same could be said of many other industries.

    In reality the big pharma argument is just a logical fallacy known as poisoning the well. It’s pure intellectual laziness. It gives the alties an excuse to ignore science (that contradicts what they have already decided to be true) because science is corrupted by drug companies.

    Reply
      Maria March 5, 2014

      I’ll definitely try an antioxidant cream for the dryness, I actually found an organic moisturizer that has both green tea and resveratrol in it, so this might be good for the acne too. the retinol might not be an option for me since my skin is also very sensitive and maybe not be necessary either, although my skin is quite dry now, many of my friends who are the same age as me have skin naturally as dry as me. but oily skin definitely would have had its pros, without the acne of course. but on the other hand, I’ve seen many people who have taken accutane decades ago and do not seem to have aged faster, despite the dryness and skin sensitivity. Salma Hayek most famously, has talked about having severe acne and taking accutane in her twenties, and she is probably the youngest looking 47 year old I’ve seen. (and says she is against skin fillers and plastic surgery). Also the people I’ve met who have taken accutane don’t seem prematurely aged and none of them have been hurt by accutane. i even know doctors who themselves have taken several courses of accutane.

      but alone the fact that accutane has been used for decades isn’t a safety guarantee really, many substances used for long periods of time are later found harmful, but like you said earlier , medicine is always risks vs. benefits.

      And well, life isn’t safe, no matter how much we want it to be so. But I feel that fear is a whole different concept for this generation, we are in an immense pool of information, and it creates a base for fear, since we are always afraid of what we do not know, and most of us don’t have the tools to make adequate conclusions from all these things we read on the internet, more or less scientific, it leaves us baffled. at least i feel helpless in the middle of it, information everywhere, knowledge in very few places.

      but i want to thank you, i’m finding this site very helpful and supportive in this matter (acne and all worries related to it), and it shows through that you want to help people.

      Reply
        Seppo March 7, 2014

        Very good points, thanks for sharing this!

        but alone the fact that accutane has been used for decades isn’t a safety guarantee really, many substances used for long periods of time are later found harmful, but like you said earlier , medicine is always risks vs. benefits.

        True, but this wasn’t my point. What I wanted to say is that doctors and scientists recognize Accutane as potentially dangerous but also potentially very helpful. So a lot of time and resources have been spent on understanding and improving the safety of the drug. And since the drug has been in use for several decades we have a lot of short and long term safety data available. But it’s certainly possible the studies have missed some effects.

        If you feel you are overwhelmed with all the information out there, I suggest you take some time to learn critical thinking and skepticsm. It’s been perhaps the most helpful thing for me. It’s very unnatural for humans since it seems out brains are wired into jumping into conclusions and trusting unreliable information. Learning even the basics of critical thinking helps a lot in making sense of the world.

        This video is a nice introduction into skepticisms and why it’s important:

        The Demon Haunted World by Carl Sagan is perhaps the best book to get started with. It’s ridiculously good and entertaining.

        I can also recommend searching for James Randi’s videos over at YouTube. They contain many excellent deconstructions of pseudoscience. The Skeptic Magazine YouTube Channel also has plenty of excellent videos.

        Finally, if you are into podcasting and audio content, I can’t recommend The Skeptic’s Guide To The Universe enough. They also cover a lot of science news, so I’m not sure if you are interested of that, but it’s worth to listen to a few episodes to see if you like it.

        Skeptoid is another good podcast. Sometimes Brian comes off as somewhat dogmatic, but you can learn a lot from listening to the process he goes through to reach his conclusions. I recommend going through the episode guide and listen to the ones you find interesting. They are all about 10 minutes, so it doesn’t take too long.

        Reply
Michele Wulf March 8, 2014

Hi there! I just wanted to add in my story about Accutane. I started Accutane 30 years ago when, at 16 with terrible out of control cystic acne, nothing else worked and we heard about this Wonder Drug! It did eventually help get rid of my acne, but not before I was already terrible scarred on my face and back. As a young girl going through this in my teens I was left with a very bad self-esteem problem throughout my life due to the scars. I have had dermabrasion, twice, and laser therapy done to minimize the scarring, but it is still there and I always feel so ugly and self-conscious. Even at 46 years old I do not wear backless dresses because of the scarring! I had to go back on Accutaine at age 26 when I started developing cysts on my back. Fortunately I was able to convince my doctor to put me right on to Accutane instead of trying all of the other medications and having the cystic acne get out of control again. It worked like a charm! Other than my normal oily skin and occasional break-outs I do not get the cystic acne anymore…..plus side, very few wrinkles! I always have people comment that I look much younger than I am. Bonus!

My daughter made it through her teen years with ‘normal acne’. We were able to control it with anti-biotics. My son on the other hand is having a terrible time. He has been on Accutane for two months. He has the cystic acne I fought as a teenager. Unfortunately we have had to take him off the Accutane because it turns out he has developed an allergy to it. Crazy! He started on the medication slowly but his face broke out terribly with the cysts. He also developed large painful cysts on his back, chest, shoulders and hips. His face swelled up after two months and he looked like a chipmunk! We took him off the Accutane and onto steroids to help with the swelling. One and a half weeks later he started back with the Accutane and woke up with his face COMPLETELY swollen and a rash over his body. I took him to the doctor, after making him go to school that way (I know, I’m a tough mom!) and they were shocked to see his condition.

I’ve been doing research and have yet to see an allergic reaction develop to Accutane. I did find that some people can become allergic to parabens which are actually in the capsules holding the medication.

The doctor is unable to put him on amoxicillin because we found out he is allergic to that. Side note – the doctor put him on amoxicillin prior to Accutane and he developed a rash ten days after starting the med.

The doctor was going to put him on minocycline put we realized his nails are blue! I guess that is a side effect we did not know about until now!

This poor kid has gone through so much. His face is full of huge painful cysts. As well as his other body parts I mentioned before. He is a young tall healthy athletic boy.

I will try the green tea for him but it is disappointing for us that the Accutane did not work.

Reply
    Seppo March 10, 2014

    Sorry to hear that your son has had to go through so much because or acne. Paraben allergy seems like a possible explanation. From what I read paraben seems to be mildly allergenic. Topically applied it can causes weak allergic reactions to sensitive people. In rare cases it apparently can cause systemic allergic reactions, something your son may be suffering from.

    If it’s indeed due to paraben allergy, then he has to be careful with what he’s eating. According to this article parabens are also found in food items. See the ‘Table 2′, you have to scroll down a bit to find a link to it (I think paragraph 7).

    There’s not much I can say to this, other than to work with your doctor to figure out what caused the allergic reaction to Accutane.

    Reply
dim August 5, 2014

Whoever wrote this article is totally clueless about the longterm damage related to accutane.I am a physician and got in the trap of trying accutane because of my cystic acne.I did not believe that any chronic side effects would occur.I WAS WRONG.During the 2 month therapy i had retinal detachment in my left eye.Now i have a permanent vision loss. Apart from that i have developed the severe longterm side effect of low libido.This side effect started while i was taking the drug and got worse after stopping it.Here is a link:

http://www.ncbi.nlm.nih.gov/pubmed/24902508/

Reply
    Seppo Puusa August 5, 2014

    The totally clueless guy wrote this article based on meta-analyses and systemic reviews looking at the safety of Accutane. As I mentioned repeatedly, by all accounts severe side effect are rare – that is, rare, not impossible or never existing.

    I’m sorry to hear you suffered permanent damage because of Accutane, you seem to be one of the very few unlucky ones. But you have provided no evidence to support your claim that the severe side effects from Accutane are under diagnosed. The paper you linked to covers 120 cases of severe side effects, but it also covers 3 different drugs and spans over a decade and 20 different countries!

    If we are generous and assume that all the cases are due to Accutane (they aren’t, but let’s be generous), then we are talking about less than 12 cases a year – in 20 different countries. That’s less than 1 case per year per country. Compare that to how many people take Accutane every year? Hundred thousand? A million?

    I’m sure the paper doesn’t cover all the cases and some are never reported. To me the paper supports what I wrote here; that severe and permanent side effects occur in very rare cases.

    Reply
      dim August 5, 2014

      You can search all over the internet.There are hundreds of reports of people who suffer from this side effect.This side effect is very under-reported.Dermatologists deny it and don’t report it as they should and patients are responsible also for not reporting this side effect because they fear of being laughed at.The drug company is also responsible for not having stated all the possible side effects in the drug leaflet!

      My friend as a physician i also believed in meta-analyses and systemic reviews but now i don’t since i have come to the conclusion that they are done unprofessionally and are unreliable.We don’t even know if in these analyses the questionnaires that were given to the patients included the sexual side effects part.The researchers might also have assumed that erectile dysfunction was due to depression which is a false assumption.Such a serious side effect should at least be stated in the drug leaflet but unfortunately it’s not.My life and the life of others has been literally destroyed by this drug.Many cannot tolerate the many side effects and commit suicide.I personally had contact with a fellow sufferer and later learned that he commited suicide because of the permanent side effects he had.

      If you want your site to be really helpful and informative then do state all the possibly permanent side effects that this drug can cause!I am sorry if you got offended but my life and the life of others has changed so much since we took this drug.Isotretinoin is a chemotherapy drug and should be given to people for acne ONLY after they have been informed for all the possible permanent side effects!

      here is some links for people who don’t believe they are being treated for acne by a chemotherapy drug:

      isotretinoin treatment of thyroid cancer:

      http://link.springer.com/article/10.1007/s00259-001-0702-4

      http://europepmc.org/abstract/MED/18854619

      isotretinoin treatment of cancer of the cervix:

      http://jnci.oxfordjournals.org/content/84/4/241.short

      isotretinoin therapy of skin cancer:

      http://jnci.oxfordjournals.org/content/84/4/235.short

      isotretinoin treatment of kidney cancer:

      http://jco.ascopubs.org/content/13/8/1950.short

      Reply
        Seppo Puusa August 6, 2014

        I agree with you that people should be made aware of all the possible side effects. If erectile dysfunction and other sexual problems are grossly under reported then that would be a huge problem. They also wouldn’t show on the meta analysis and systemic review papers I looked at. It doesn’t mean that the meta analysis papers are unprofessionally done or unreliable. It just means there’s a problem with adverse effects tracking for isotretinoin.

        I’ll be happy to make corrections to the post if I have some reasonably reliable data to base them on. I can’t write anything based on internet reports since there are no controls in place and it’s impossible to determine prevalence.

        Reply
Eve August 20, 2014

I am literally about to start Roaccutane (trading name in Australia) in 3 weeks and I am glad I came across this article. I am a 26 y/o female who has had acne since the age of 12. Throughout the 14 years, the acne has changed in severity, from cystic to non-cystic to blackheads and milia. I have tried all the usual suspects to improve and/or ‘cure’ my acne ie. antibiotics, the pill, topical creams/serums, microdermabrasion, and all these treatments combined! My main concerns revolve around premature aging and decreased libido. Is there any scientific evidence of this drug decreasing female libido? Are there any reported and researched cases about women who have suffered from decreased libido even after ceasing taking the medication?

Thanks again for a great, informative article.

Reply
    Seppo Puusa August 20, 2014

    Unfortunately nobody has followed up on how Accutane affects libido or erection after the Mexican study, and that study only involved men. There’s no scientific evidence to show how it affects libido in women. There are lots of anecdotal reports from women who say Accutane caused vaginal dryness and decreased libido.

    Reply
Katerina December 2, 2014

Accutane DOES cause premature aging. I was 29 when I got my script for Accutane. I knew a classmate age 18 who took Accutane, but she looked 35. I did not make the connection until I started taking Accutane myself. I looked so youthful, but within a few months of taking Accutane, I started to develop jowls and aged facial skin and started looking like my 18-year-old friend who looked 35. I was worried, but I continued the course. I had all manner of side effects. I lost my normal personality and became careless, depressed and aggressive, which lasted until I stopped the course of treatment. Other side effects lasted for years, including severely dry eyes that required ophthalmologic treatment, arthritis of the hands and knees and aged dermis. I finally had to have surgery to correct the aged dermal damage. I was still so young to be having age-related surgery.

Reply
Add Your Reply

Leave a Comment: