The Dark Side of Acne Treatments
Image Courtesy: Dazed
What lead me to Isotretinoin, more commonly known by its brand name Accutane, was desperation. Since my battle with acne started early in elementary school, I couldn't remember a time where my skin wasn't riddled with bumps. This prescription, which seemed like a last-ditch effort, ended up being one of the biggest confidence boosts I've ever experienced; but it didn't come without its fair share of side effects.
I had waited long enough to see results with previous acne treatments, all of which were inevitably pushed to the back of my medicine cabinet after I was prescribed my new regimen. It took two years for me to be persuaded into Accutane by my dermatologist, primarily because I dreaded the monthly bloodwork to monitor blood fat levels and changes to the liver. Although I expected this to be the worst part of the experience, the anticipation killed me. You can expect a two to three month waiting period between making your decision and taking your first dose due to the copious amount of conditions that need to be met, including blood work, a negative pregnancy test, and participation in the iPledge program.
Throughout my experience bloodwork became the least of my worries, especially compared to the copious amount of side effects that I and other patients have encountered. I went through the process of taking Accutane twice, and during my second round, the amount of blood work I underwent was cut down considerably. A study done in 2016 showed that the monthly blood work is not necessary, and instead, it is only needed twice: before treatment to record baseline blood fat levels and liver conditions and two months into treatment to record the patient's peak levels. This is not only a victory for those who fear needles, but it also lessens the costs associated with Accutane.
Accutane is known to have a long list of side effects tacked onto it. A prominent pharmaceutical manufacturer, Hoffmann-La Roche Inc., stopped production in 2009 due to a decline in its use and personal injury lawsuits, both presumably due to the associated dangers. Severe side effects include elevated blood fat levels, injuries to the liver, and birth defects. During the waiting period before the first dosage, a negative pregnancy test and preliminary blood testing are required to prevent these instances. A government-run program, iPledge, was also established to avoid the irresponsible use of Accutane. The program requires patients to state their two methods of birth control and affirm their monthly dermatologist appointments. All side effects are not this severe, and most are easily treatable.
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Complaints about less-severe side effects are far more common, and I experienced nearly all of them myself. Accutane drastically reduces the skin's production of oil, so I was shocked by the sudden change in my normally oily skin. When asking others about their experience, they described that their skin would "flake" or "peel" off. Nothing is spared of this dryness either; chapped lips, nosebleeds from the dryness, and dry eyes are common side effects as well. Throughout my experience on Accutane, the first two months especially, I couldn't skip a layer of moisturizer, and wherever I went, my Chapstick followed. As someone who typically has oily skin, and never had to deal with dryness before, this was proof that it was working. I was told to wait six months before seeing results with prior regimens, so the drastic changes I was seeing in my skin were reliefs more than they were bothers.
Though much of the dryness subsided as I continued taking the medication, the farther I got into the six months I couldn't go a day without experiencing headaches and back pain. The muscle pains got so severe, I attributed them to a sports-related injury because I couldn't believe that Accutane could cause that level of pain. Through these times, I reminded myself that I had already been through eight years' worth of different regimens before choosing Accutane. The six months of side effects paled in comparison to the self-confidence issues I experienced. Along with questions about these pains, my dermatologists would ask about ‘moodiness' at our monthly appointments, due to the link between Accutane and depression. While I didn't undergo any serious changes regarding my mood, I wouldn't have admitted it was due to my desperation to stay on this ‘miracle drug.'
There are plenty of Accutane horror stories that can be found with a simple Google search, but I found that many patients decide that its results outweigh the temporary side effects. A close friend of mine has claimed that "that sh*t saves lives," and Kali Kushner, who went viral for sharing her process with Accutane on Instagram, claims that it's "like magic." This opinion may be the common denominator, but within the small group, I questioned there were side effects reported that weren't similar to my own, like weight gain, hair loss, or a worsening in acne before improvement. By no means is Accutane for everyone, and it's even been found that its success rate is decreasing.
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Because of its potency, Accutane is meant for cases with severe, persistent acne that can't be treated with prior antibiotics. It's found to "cure" half of its patients in around four to six months, depending on the dosage used. Scientific studies ascertain that Accutane is the most effective of acne treatments, primarily because it targets all possible causes. It works at the cellular level to prevent clogged pores and reduces oil production by 90%, which causes severe dryness. Although, its long-term success rate is dwindling due to its use in less-severe cases. Because of this, younger patients are more likely to undergo multiple treatments of Accutane. Having been on Accutane twice myself, I can attest to this, and any bumps that emerged post-treatment resulted in a call to my dermatologist.
In an article for Byrdie, six women shared their experiences with Accutane. While I do agree with one claim that it's a "life-changing medication," it was another explanation that caught my attention. One woman interviewed said, "Do I regret being on Accutane? I honestly have no idea. I go back and forth." While I can thank Accutane for ending my struggle with acne and doing wonders for my self-confidence, I still experience my fair share of breakouts. While there is no true "cure" for acne, Accutane gets pretty close – but not without its side effects.
Behind each before-and-after pictures, there is six months' worth of side effects and conditions to meet. Accutane shouldn't be the first option in acne treatments, but it can be one of them. Kushner, whose pictures are included above, used Accutane to combat her acne, but also preaches that "your skin does not define you" and that you shouldn't feel pressured to undergo a drastic treatment, like Accutane, for anyone but yourself. Whatever your chosen treatment plan is is part of your journey. Taking steps for self-improvement, for me towards self-confidence, isn't universal.
Strike Out,
Writer: Haley Hauk-Landon
Editors: Giselle Parks and Savannah Tindall
Tallahassee