Roaccutane – The Miracle Acne cure?
Stubborn acne not improving despite religiously applying skincare products, oral antibiotics or regular facials?
What is Roaccutane?
Roaccutane’s main ingredient is Isotretinoin, a derivative of Vitamin A.
Having been in the market since the 1980s, its effects are well studied and is used regularly by skin doctors all over the world to treat moderate to severe acne.
You may have heard of it under different brand names such as Roaccutane, Accutane, Oratane, Acnotin and Nimegen.
How does Roaccutane work?
Roaccutane is currently the single most effective medication available for acne treatment because it is the only medication that can target all 4 causes of Acne Formation.
Excessive sebum (oil) production
Clogged pores due to abnormal skin turnover
Bacterial P.acnes proliferation
Other forms of acne treatment such as topical creams, oral antibiotics, facials or lasers can only partially target these factors.
Sounds great! Lets get started!
Not so fast, even though Roaccutane is one of the most effective ways to treat acne, there are some factors to consider.
How long before I see results? What is the duration of treatment?
Roaccutane requires long term commitment.
Studies report that majority of patients can achieve acne clearance after 16 to 20 weeks. Please note that this time frame is dependent on the patient's dosage and body weight.
As such, the treatment duration can range between 4 to 12 months with the goal to achieve a total treatment dose accumulation of 120mg/kg.
After completing a course of Roaccutane, Acne clearance is usually permanent with some studies reporting less than 3% recurrence risk.
How much should I take? Higher dosage = better?
Previous studies describe the starting dose at 0.5 to 1mg/kg/day. Assuming a body weight of 50kg, that is between 25 to 50mg a day.
Depending on severity, Dr Edwin prefers to start patients at a lower dose of 20mg a day as newer studies show that lower doses in Asians are just as effective AND have lower side effect risks + cost savings.
An expert skin doctor will be able to tailor a treatment course for you.
For example, if you have moderate acne, Dr Edwin may choose to start at an every other day (EOD) dosing instead of a daily dosing to minimise the risk of purging and side effects whilst gradually increasing the dose over several months.
Roaccutane can lead to birth defects when taken during pregnancy, hence it is of paramount importance that birth control methods be utilized when females are on this medication.
Of note, Roaccutane does not impair fertility and does not reduce your ability to conceive.
Patients who are breastfeeding or have a medical history of Liver or Kidney disease, high blood cholesterol levels or Hypervitaminosis A are also not suitable candidates for Roaccutane treatment.
How long must I stop Roaccutane for if I wish to get pregnant?
It is recommended to stop Roaccutane for at least 1 month before trying to conceive.
What are the common side effects?
Roaccutane reduces oil and sebum production all over the skin. This manifests most commonly as dry eyes and chapped lips which can be easily remedied with eye drops and lip balm.
Mild joint and muscle aches
Rest assured, for most people, these mild aches are not significant enough to impact your daily routine and exercises.
For the first 4-6 weeks, acne may worsen before they gradually improve.
Do not be demoralized!
To minimise the risk of purging, Dr Edwin has 2 methods. He covers patients with a course of compatible oral antibiotics and prefers to start Roaccutane at a lower dose in the first 2 months with gradual increments over time.
There have been scattered reports of individuals reporting changes in mood with symptoms suggestive of depression whilst on Roaccutane.
However, to date there is no compelling evidence from studies to suggest a direct link between oral isotretinoin and low mood. Dr Edwin will schedule regular follow ups to monitor for such issues.
Must I stop my facials or laser treatments?
The latest studies report that it is generally safe to continue with facials and lasers and there is no increased risk of poor wound healing ever after ablative laser treatments whilst on Roaccutane.
Dr Edwin will customize a safe and effective treatment plan which will comprise of the following treatment options to hasten the acne treatment and clearance process.