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Acne (or as I call it, blackheads) is a skin disease that is caused by changes in the structure of the sebaceous glands and hair follicles. The disease is inflammatory in nature.
Interestingly, for the first time anke was registered as a disease by a doctor at the court of King Justinian in Byzantium.
The exact mechanism of the development of the disease has not been established by scientists, but it is generally accepted that this occurs due to changes in the process of skin exfoliation. The ability of the sebaceous glands to resist bacteria decreases and they become inflamed due to infections. Some cosmetic ingredients can also cause acne. But most often the disease is associated with puberty.
The active component of the drug – isotretinoin – is a stereoisomer of trans-retinoic acid. At the moment, the exact biochemical mechanism of reactions that occur in the human body after ingestion of the active substance is not known. But, one way or another, as a result, the condition even in patients with severe forms of acne improves. Accutane suppresses the activity of the sebaceous glands, reducing them (this fact has been established by histological studies). Accutane also prevents inflammation of the skin.
Composition and form of release
The active ingredient is isotretinoin. Natural wax, soybean oil (several types of various cleaning and hydrogenation) are added as auxiliary. The shell consists of gelatin, glycerol, sorbitol, mannitol, starch, titanium dioxide, iron oxide, printing ink.
Accutane is available in the form of tablets with different contents of the active substance (10 mg and 20 mg). Outwardly, they are similar (oval, dark brown capsules), although capsules with 10 mg of the active substance are somewhat smaller. The main difference will be the engraving, in the Canadian pharmacy you will find a quality drug.
They are packed in ten pieces in blisters. There are three blisters in one individual cardboard box.
In the instructions for use, the manufacturer draws attention to the fact that therapy can only be carried out by a specialist who has experience working with this pharmacological product or its analogues. The doctor must be aware of the peculiarity of the active substance, as well as conduct proper monitoring.
Capsules are taken once or twice a day before meals.
Adults, adolescents and the elderly are recommended to undergo treatment according to a specific scheme. The doctor calculates the dosage (0.5 mg per kg of the patient’s body weight). But such calculations in any case will be approximate and will need to be adjusted during therapy.
Remission depends not so much on the duration of therapy, but on the correct dosing. Depending on the specific optimal portion of the substance, the course is from 16 to 24 weeks.
Studies show that acne resolves after the first course of therapy. If the disease returns two months after remission, then the therapy is repeated in the same dosages as for the first time. Please note that the positive effect of the drug may occur for two months after stopping the capsules.
Patients with acute or chronic disorders of the kidneys need to adjust the dosage. Therapy begins with 10 mg of the active substance (one capsule) per day. Gradually it is increased to 1 mg per kg of the patient’s body weight.
The manufacturer has not conducted preclinical studies in the age group of patients under 12 years of age. Due to lack of information, Accutane is not prescribed to children.
During treatment, patients may experience symptoms of individual susceptibility or overdose. If the symptoms are not severe, then the dosage can be reduced. If the condition worsens, the course is canceled.
Indications for use
Accutane is recommended for use during the treatment of acne in adolescents and adults, if treatment with cosmetics and antibiotics has not worked.
ICD-10 classification: Acne (L70).
Undesirable conditions during the course can be classified as follows:
Mental condition. There is a risk of developing depression, increased aggressiveness and excitability, frequent mood swings, suicidal thoughts. Patients with a predisposition to these conditions should consult with a psychotherapist before starting the course.
Leather. There may be an exacerbation of acne in the first week of treatment. Some patients noted the development of abnormal reddening of the skin, Stevens-Johnson syndrome, TEN.
Allergy. Manifestations of hypersensitivity to the drug are quite rare, but are expressed in the form of anaphylactic shock or bruises and spots on the skin.
Vision. Some patients complain of a feeling of dryness in the eye, deterioration in the ability to see in the dark, inflammation and the appearance of opacities.
Musculoskeletal system. There is local pain in the joints, muscles. In patients who received increased doses of the drug, for several years after treatment, when using other drugs to eliminate dyskeratosis, changes in the structure of the bones may occur.
Liver. Patients during the course need to control the level of enzymes because of the risk of an arbitrary increase in their activity.
Contraindications for use
Accutane is strictly prohibited for women who are pregnant or breastfeeding. Also, do not prescribe it to patients with increased susceptibility to the components of the composition, liver failure, elevated levels of vitamin A and those who take tetracyclines. Pay attention to the content of soybean oil in capsules.
It is necessary to store the capsules at room temperature away from sunlight and heating devices in the original factory packaging. The deadline for use is indicated on the individual carton by the manufacturer.
Use during pregnancy and breastfeeding
Accutane is absolutely contraindicated in pregnant women. Prior to the start of the course of capsules, pregnancy must be excluded. During treatment, women must use effective methods of contraception. If pregnancy occurs during the course or within a month after, the risk of developing fetal defects is extremely high.
The instruction describes the nature of these pathologies. These include abnormal formation of the neural tube, malformations of the bones of the skull (cleft palate, cleft lip), absence of auricles, visual defects, underdevelopment of the heart and vascular system, abnormal sizes of the thymus and some glands. In addition, in women who carry a fetus during the course of the drug, the risk of miscarriage is much higher.
If pregnancy was established during treatment, then the woman should contact a specialist in the pathology of fetal development for advice and stop the course.
The active ingredient is excreted in breast milk. It is forbidden to take the course while breastfeeding.
There is no exact information, but it should be borne in mind that alcohol increases the load on the kidneys and liver, where the active component is metabolized.
The risk of hypervitaminosis A (a fat-soluble vitamin) increases while taking this drug. That is why it is better to limit the drug intake of the vitamin in the body. For example, exclude biologically active additives with its content from the diet.
Tetracyclines should not be used together with this anti-acne remedy due to the possibility of fixing a specific increased pressure inside the skull (“pseudotumor” of the brain).
Often, with the parallel treatment of acne with capsules and products for external use with a keratolytic or exfoliative effect.
Before prescribing Accutane to a woman of reproductive age, it is necessary to make sure that these factors are met:
The patient has a severe form of acne, which could not be cured with other drugs.
The woman was advised of the risk of fetal pathology due to taking the capsules.
A consultation was held and informed about the need for regular examination by a doctor (every month).
The patient has the opportunity to prevent pregnancy on her own (reliable methods of contraception). She agrees to perform pregnancy tests during treatment and five weeks after the end.
The treatment regimen is based on the menstrual cycle (the beginning of the course is on the 2nd or 3rd day of the cycle).
Studies show that the drug does not have a similar effect on the reproductive capabilities of men. If a man who takes Accutane lives with a woman, then he must inform her about the properties of this drug and acquaint her with the appearance of the capsules. Such precautions are necessary so that a woman does not accidentally take the capsule.
It should be borne in mind that small doses of progesterone, as a contraceptive, may be ineffective.
The patient is forbidden to give unused capsules to other people who have not been consulted by a doctor regarding the need for use.
Patients are prohibited from becoming blood donors during the course and for a month after. This is due to the risk of transfusion of blood, which contains the active component of the drug, to pregnant women.
In order to fully protect women from the harmful effects of the product on the fetus, the manufacturer issues separate booklets about the indicated properties of the active substance.
Extremely rarely, patients complained of changes in visual acuity at night, drowsiness. This must be taken into account when it is necessary to drive a car or complex mechanisms. At the first manifestations of the described states, it is necessary to abandon activities that require increased attentiveness.
During therapy, the skin becomes more sensitive, there is a need to use protection against exposure to ultraviolet rays. It is also worth refusing about procedures that can potentially injure the skin (not only on the face). These include, for example, hair removal with wax, sugar paste or laser, chemical skin cleansing and others.
The patient needs a dermatologist to choose cosmetic or therapeutic products to moisturize the skin that will not clog pores and glands. The skin may become dry during treatment.