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Isotretinoin isnt an ideal solution, but its one of the best weve got

caroline acne accutane afterEven though I experienced annoying side effects, my Accutane results were worth it. Caroline Praderio/INSIDER

  • My adult resisted every treatment I threw at it.
  • So my doctor recommended a controversial drug popularly known as .
  • It can offer a prolonged or even permanent acne cure.
  • Accutane's side effects were nasty, but for me, the results were worth it.

Imagine walking into your kitchen to find that your stove is on fire. Imagine throwing on buckets of water, spraying an extinguisher, desperately trying to smother the blaze with a blanket. Now imagine that — no matter what you do — the fire just keeps burning.

That's what having adult acne feels like.

In the 12 years I battled acne, I learned one very important thing: It's really misunderstood. Acne products are usually marketed to teenagers, but many acne patients are adults. We brush blemishes aside as minor annoyances, but they can , according to the American Academy of Dermatology (AAD). And, whether we do it intentionally or not, many of us assume people with acne are probably just careless or dirty.

The truth is that most acne sufferers you know have tried everything to take "better" care of their skin. I know from experience. I found a cure for my painful blemishes, but not until I tried the drug popularly known as Accutane — a controversial, heavy-duty medication with notorious side effects and scary risks.

Being on Accutane wasn't easy, but for me, the results were worth it — and I'd do it all again in a heartbeat.

Pick a treatment, any treatment: I tried almost everything in the book

I used the pill and three different antibiotics to treat my acne over the years.

I come from a family of acne sufferers, and though my acne was never severe, it was crazily persistent. I treated it with oral antibiotics, birth control pills, and strong prescription creams. I tried natural treatments, supplements, "clean" diets, intense pillowcase-washing regimens.

Most interventions helped for a time, but no matter what, the acne came back, inflamed and painful. Covering it with makeup made it even worse. By the time I reached age 24 — when most people's teenage pimples have faded — I was still fighting. And I had exhausted almost every option.

So I tried a controversial treatment with big risks

What my acne looked like: not severe, but persistent. Caroline Praderio/INSIDER

I got so frustrated that, in the summer of 2015, I made an appointment with a new dermatologist. She recommended a six-month course of a powerful prescription pill called isotretinoin, better known by the now-defunct brand name Accutane. A single course typically lasts and often offers a prolonged cure for people who take it, according to the AAD. For some patients, this cure is permanent.

Read more:10 of your most burning questions about Accutane, answered by dermatologists

Isotretinoin is a derivative of vitamin A, and it's the only acne medication that , the AAD explains. It combats excess oil production, an excess ofPropionibacterium acnesbacteria on the skin, clogged pores, and inflammation.

What's the catch?

To start, there's a whole slew of unpleasant side effects (including dry eyes, dry lips, nose bleeds, sore joints, and more). The drug also , so women taking it need to be very careful about not getting pregnant. And the potential complications don't end there.

Ever since it got FDA approval in 1982, isotretinoin has been linked to some serious health problems

Perform a quick online search and you'll easily find stories claiming isotretinoin can cause inflammatory bowel disease and irritable bowel syndrome, depression, and suicide.

The stories about mental health problems are particularly scary. Between 1982 and 2000, the FDA of depression, suicidal ideation, suicide attempts, or suicide in Americans taking isotretinoin, according to an article published in the New England Journal of Medicine. There were some highly publicized cases, too. In 2000, for example, a US congressman blamed Accutane for the suicide of his 17-year-old son.

But doctors say the drug's benefits can outweigh risks

Accutane has scary risks, but the benefits can be big. Shutterstock

"It's a heavy-duty medication with some potentially serious side effects; however, it is safe when properly used and when patients are properly monitored," Joshua Zeichner, assistant professor of dermatology at Mount Sinai Medical Center in New York City, told INSIDER. "There's a lot of negative publicity and you just have to speak to your doctor about what the real data is."

That real data is pretty encouraging.

For example, a recent review of evidence found no increased risk of inflammatory bowel disease in people taking isotretinoin. And scientists have still not been able to definitively prove that isotretinoincausesmental health problems, the AAD has noted. In 2019, researchers on the issue and found "weak evidence" to support a connection between isotretinoin and depression or suicide. And in 2019, another review of 31 studies concluded that the medicine does not appear to be associated with higher depression risk.

Plus, some experts say that, because it treats acne so well, isotretinoin might actuallyimprovemental health

"I personally have one specific patient who had clinical depression, was on antidepressants and [was] being followed by a psychologist," Zeichner said. "And after treating with isotretinoin, [his] face was totally clear, [he] had a huge boost in confidence, and [he] went off his depression meds. When I tell you it's life-changing, it's really life-changing."

Read more:16 subtle ways you could be damaging your skin without realizing it

The potential links between isotretinoin, IBD and IBS, depression, and suicide are still controversial. For now, the AAD advises doctors to closely monitor the mental health of their patients on the drug. But for some people — me included — the potential risks seem well worth the reward.

I took the first pill and hoped for the best

Here's how my skin looked about two months into treatment. Caroline Praderio/INSIDER

I began treatment in September 2015. Two days in, my lips became dry and flaky. My nose bled almost every day. Red rashes spread up and down my arms.

Then, about three months in, my skin started to calm. My last big zit flared up in late November, but after that — nothing. I ran to the mirror every morning to marvel at my smooth face, just to make sure it wasn't a dream.

The last two months of treatment were the worst

Though I never experienced mental health problems on the drug, the side effects did get worse toward the end of treatment. My knees, hips, and lower back grew so sore I slept with ice packs strapped to my body. My eyes and lips turned red thanks to dryness and irritation. I slathered on lip balm every two minutes — that is not an exaggeration.

And every month I visited the dermatologist for pregnancy and blood tests. Female patients on isotretinoin aren't allowed to pick up their monthly pills unless they take a negative pregnancy test at a doctor's office — it's part of a mandatory FDA program meant to cut down on the number of isotretinoin-related birth defects.

I hid my face a lot during those days. Caroline Praderio/INSIDER

The blood tests monitored my liver function, since isotretinoin can be a lot for your liver to handle. On that note: My dermatologist also advised me to limit (but not totally stop) my alcohol consumption. Suffice it to say that my six months on isotretinoin were not the wildest of my early 20s.

But finally, in March 2019, I finished my course. My skin was totally clear besides some pesky red marks that had already begun to fade. It was like magic. For years, I had dragged my acne around like a bulky suitcase filled with only the awful parts of being a teenager. Then, all of a sudden, I was free.

Isotretinoin isn't an ideal solution, but it's one of the best we've got

Here's how my skin looks now, without any foundation. Caroline Praderio/INSIDER The frustrating truth is that there is still no treatment for acne that works 100% of the time, for 100% of patients, and just about every treatment has its downsides.

Prescription and over-the-counter creams can irritate the skin. Birth control pills can have their own side effects. Antibiotics have scary implications given the rise of drug-resistant bacteria. And besides its nasty side effects, isotretinoin can be prohibitively expensive: The pills, monthly office visits, and blood tests cost me around 0 out of pocket — even with insurance.

"I think the public would really like to see newer treatments," , associate professor of dermatology at the David Geffen School of Medicine at UCLA, told INSIDER. "[But] there's very little support for research in skin disease. Companies are trying to develop new products, but we still need a basic understanding of this disease. We still need research that might not lead to direct drug development. It's frustrating for dermatologists."

At the moment we're stuck with the treatments we already have. It's been more than two years since I finished my isotretinoin treatment, and though I still get the occasional pimple (especially if I wear lots of makeup), my skin is most often completely clear and remains vastly improved. Isotretinoin may not be right for everyone, but it's the treatment that finally worked for me.






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Date: 15.12.2018, 14:35 / Views: 42451