Isotrétinoïne (Accutane)

isotretinoin has revoluded the treatment of acne since it became available in South Africa in 1984, according to the National Dermatology Working Group led by Dr. Dave Presbury.

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It is the only treatment that affects all four etiological factors involved in the acne process namely:

  • sebum production
  • comedogenesis
  • colonization of the surface of the skin and follicular leads with Propionibacterium acnes and monocytes and chemotaxis with an anti-inflammatory effect.

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Isotretinoin is the treatment of choice for:

  • severe acne (nodulocystic acne, and the extent of acne affecting the face and trunk)
  • less of acne, especially when scarring is going on
  • where other options have failed or are not suitable or not tolerated.

Isotretinoin may also be prescribed for other conditions: Seborrhea, Gram-negative folliculitis, Rosacea, and Hidradentis suppurative.

More and more patients are failing to respond to long-term antibiotics, both topical creams or tablets. This is due to the increased resistance of P. acnes to many antibiotics.

Studies have shown that even people with mild to moderate acne can develop scars for which long-term management remains a problem.

Acne scars can have long-term physical and emotional ramifications. Other treatments are slower at the beginning of the action, and scarring may occur before they take effect.

Isotretinoin (Accutane) Dosage

In 60 at 80% of people, treatment may lead to a definitive cure at a dose between 0,5 - 1 mg / kg body weight daily for 16 - 20 weeks. New evidence suggests that a cumulative dose of 120 mg / kg body weight during the course of a daily dose of at least 0,75 mg / kg body weight may be greater than the duration of treatment.

If the acne persists or reappears a second complete series may be considered some time after two months apart as a result of the treatment.

Please note that some people - those with multiple macrocomedones and polycystic ovarian syndrome may take a long time to respond to treatment. In about 30% of patients, acne is infected with Staphylococcus aureus bacteria. Bacterial infections can be treated with appropriate antibiotics. Note that tetracyclines should not be taken with Accutane.

With over 60 - 80% cure rate, 20 to 40 percent of people need an oral antibiotic supplement, hormone therapy (Diane) or repeat Isotretinoin.

People who may need a second internship include:

  • Those with severe acne
  • Those who have worsening of acne before the age of 15
  • Women aged 25 at the beginning of treatment
  • Those with a long history of acne
  • Those with loads of acne on their backs or on the chest
  • The presence of macrocomedones
  • Polycystic Ovary Syndrome

An acne flare can be expected in 6 percent of patients at the beginning of the course.

Isotretinoin (Accutane) Side Effects

The keywords here are:

  • Certainly not before or during pregnancy because it can lead to defects of the unborn child
  • Depression - patients should be counseled about possible mood changes, and if severe, the medication should be stopped and the patient sent for psychiatric help.
  • Liver function of lipids and monitoring in people with diabetes or inherited high levels of triglycerides
  • Do not take with antibiotics (tetracyclines). The combination of tetracycline antibiotics and tretizen 20 It is contraindicated that in rare cases everyone may induce benign intracranial hypertension.

It is well known that the use of Isotretinoin before and during pregnancy may have an impact on the development of the fetus, and may lead to congenital malformations.

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