Isotretinoin (Roaccutane): Basics

Written by Dr. K on 24 March 2021

What is Isotretinoin or Roaccutane?

Isotretinoin (ai·sow·truh·tee·now·uhn) is a prescription medication for the treatment of moderate to severe acne. It is a Vitamin A derivative, a retinoid. Isotretinoin is also known by its brand names including Absorica®, Accutane®, Amnesteem®, Claravis®, Myorisan®, Roaccutane®, Sotret®, and Zenatane™.

It was first studied in the 1960s in Switzerland for its potential treatment for cancer. The Food and Drug Administration (FDA) approved it for use for treating acne in 1982. Since then, it has become synonymous with being a wonder drug for patients suffering from intractable acne.

Uses

Isotretinoin is a gold standard medication for the treatment of severe acne. But besides that, it is also used in other follicular skin conditions like:

  • Rosacea
  • Sebborhea
  • Hidraadenitis Suppurativa
  • Scalp Folliculitis

It is also used as treatments for the following conditions:

  • Prevention of squamous cell cancers – a type of skin cancer
  • Neuroblastoma – a type of nerve cancer
  • harlequin-type ichthyosis
  • Lamellar ichthyosis
  • Grover disease
  • Xeroderma pigmentosum
  • Extensive actinic keratoses
  • Discoid lupus erythematosus
  • Granuloma annulare
  • Sarcoidosis

Method of Action

In the treatment of acne, Isotretinoin targets 5 main functions within the pathways leading to the development of acne:

  • decreases the production of sebum in the skin
  • reduces the size of sebaceous glands in the skin
  • inhibits the growth of acne-producing bacteria
  • anti-inflammatory properties
  • decreases follicular occlusion

Contraindications

Isotretinoin cannot be taken by pregnant women or women intending to become pregnant.

Whilst on Isotretinoin, patients are not allowed to donate blood, in the event the blood is given to pregnant women.

Isotretinoin also cannot be given to patients with hyperlipidaemia (high fats, triglycerides, and cholesterol).

Sources

References:

  1. Advice on the safe introduction and continued use of isotretinoin in acne in the UK 2010 – MJD Goodfield, NH Cox, A Bowser, JC McMillan, LG Millard, NB Simpson, AD Ormerod, BJD, Vol. 162, No. 5, June 2010 (p1172-1179)
  2. Mollan SP, Woodcock M, Siddiqi R, Huntbach J, Good P, Scott RA. Does use of isotretinoin rule out a career in flying? Br J Ophthalmol. 2006 Aug;90(8):957-9. PubMed.
  3. Accessed on 24.3.2021 https://www.aad.org/public/diseases/acne/derm-treat/isotretinoin/safety
  4. NICE BNF UK – Isotretinoin

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