In Europe, Canada, and the United Kingdom, it is known as Roaccutane. Roche’s patent expired in 2001. Rival companies earned FDA approval in late 2002. Versions now available to the public are marketed under the names Amnestreem, Claravis and Sotret.
Like Retin-A and other topical retinoids used to treat acne, isotretinoin is derived from Vitamin A. The difference is that isotretinoin is an oral retinoid, one that is taken by mouth rather than applied to the skin.
What makes Accutane and results it delivers unique among all of the current oral acne treatments available in that it affects all of the underlying factors behind the process of acne. Accutane is highly effective, but is also a controversial acne treatment option. While Vitamin A has tremendous therapeutic effects on the skin, however as the body does not readily excrete vitamin A, large doses can easily build up to toxic levels, potentially causing serious side effects.
Most cases of severe acne respond to a single four to six-month treatment course. In general, pustules heal more quickly than papules or nodules. Also, lesions on the face, upper arms, and legs tend to respond more quickly than lesions on the back or chest. In some cases, treatment is started on a low dose in order to help the skin get acclimated to the drug before increasing to a higher dose in the months that follow.
For some people, the drug has lasting therapeutic effects even long after Accutane treatment has been discontinued. However, one third of people who have taken Accutane will have a relapse of their acne within the first three years after treatment. In some people, both sebum and P.acnes levels increase once Accutane treatment is complete. This leads to a recurrence of acne after an otherwise very effective treatment course.In most cases, oral antibiotics or a second Accutane treatment course may be attempted after a two-month rest period, and rarely, even a third course if necessary.
However, in most cases in which there is recurrence of the acne soon after an Accutane treatment course is completed, further evaluation may be helpful in trying to determine whether hormonal influences are a factor. If hormonal influences are found to be at work, this would then mean that other options should also be considered either instead of or in addition to oral isotretinoin treatment.