Isotretinoin (Amnesteem, Claravis, or Sotret) is a powerful medicine for severe acne that cannot be cleared up with other medicines. It is related to vitamin A. Most people need to take it for 3 to 6 months.
This medicine unclogs skin pores and shrinks oil glands. It can reduce the scars and emotional pain of severe acne. But this medicine can have severe side effects.
Isotretinoin can cause side effects. The most serious side effects occur in women who are pregnant or get pregnant while taking it. They may have a miscarriage, or their infant may be born with severe birth defects. Other serious side effects are rare.
The U.S. Food and Drug Administration (FDA) warns that this medicine has been linked with depression, psychosis, and, in rare cases, suicidal thoughts or suicide attempts. The link between this medicine and depression is not clear, and it is being watched very closely. Talk with your doctor to decide if this medicine is right for you or your child. See your doctor if you or your child takes isotretinoin and has signs of depression.
Most people who take this medicine have some of the less serious side effects. These include dry skin, dry mouth, chapped lips, nosebleeds, dry eyes, and trouble wearing contact lenses. These side effects usually are not a big problem and can be treated with moisturizers, artificial tears, and other products. If you have dry eyes while taking this medicine, you may have to wear glasses instead of contact lenses. Your skin also could sunburn more easily, so make sure to use sunscreen.
This medicine can raise the level of certain fats (triglycerides) in your blood. So you may be more likely to get health problems such as heart disease. For this reason, you need to have your triglyceride levels checked before you start this medicine and every 4 to 6 weeks while you are taking it. You also need blood tests to make sure that the medicine isn't harming your liver.
Headaches and muscle or joint pain are less common side effects that most people can treat with over-the-counter pain medicine. Muscle and joint pain are more common in people who exercise often.
Your doctor might recommend this medicine if:
|Take isotretinoin||Don't take isotretinoin|
|What is usually involved?|
|What are the benefits?|
|What are the risks and side effects?|
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"I didn't think I needed to worry too much about my acne. So far it is mostly whiteheads and blackheads. But my dad has bad acne scars. I figure I am heading the same way if I don't do something about it, so I'm going to talk to my doctor about taking medicine."
— Jason, age 16
"My doctor said that it would be reasonable for me to try a medicine like Sotret for my acne. But my husband and I are thinking of having kids, and taking the medicine would mean putting that off for about 6 months or so. I'm going to take some time to think it over and talk to my husband, then decide."
— Anne, age 24
"I have had bad acne ever since I was 13. It was really embarrassing, and it was hard to make friends. It was like people only saw my acne. A couple years ago, my doctor put me on isotretinoin. It has changed my life. My acne is so much better and I don't feel so self-conscious. I am more outgoing, and I have made some really good friends. I even have a girlfriend. When I see old pictures of myself, it's like looking at a different person."
— Steve, age 18
"I've noticed that my daughter has become a lot more withdrawn and shy since she became a teenager. I think it might be related to her acne. She has quite a few pimples, and sometimes she gets a really severe one. I know that it bothers her, because she has asked me several times if she will outgrow it soon. I'm going to ask her if she wants to read up on isotretinoin and then we can see what the doctor says."
— Barb, age 37
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to take isotretinoin
Reasons not to take isotretinoin
I want to do everything I can to treat my acne.
I want to take medicines that are not as strong as isotretinoin for my acne.
I don't mind using two forms of birth control while I'm taking this medicine (women only).
I'm not willing to use two forms of birth control (women only).
I'm not concerned about the side effects of this medicine.
I'm very concerned about the side effects of this medicine.
I feel bad about how I look because of my acne.
I don't feel bad about how I look because of my acne.
My other important reasons:
My other important reasons:
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
NOT taking isotretinoin
1. How bad does your acne have to be before you consider taking isotretinoin?
2. Which of the following are side effects of isotretinoin?
3. How long does a woman have to use two forms of birth control if she takes isotretinoin?
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
3. Use the following space to list questions, concerns, and next steps.
|Primary Medical Reviewer||Kathleen Romito, MD - Family Medicine|
|Specialist Medical Reviewer||E. Gregory Thompson, MD - Internal Medicine|