Isotretinoin: Contraindications, Properties And Benefits

The isotretinoin , is a drug used to treat severe cases of acne or cystic acne and sometimes is medicated for some types of aggressive cancer, serious or severe skin conditions.

It was developed as a chemotherapy drug for the treatment of cancer in the brain, colon, and pancreatic. Although today it is still used as a cancer treatment thanks to its ability to produce apoptosis in rapidly dividing cells .

It is a medicine used to treat severe conditions , positioning it as a remedy whose active principle is quite strong, that is, this type of medicine must be indicated by a doctor with a prior physical evaluation along with respective laboratory tests.

Acne and Isotretinoin

Acne is a skin disease with a high impact on the body aesthetics of the person who suffers it , due to injuries caused to the skin or scars that remain as a result of the injury.

Fortunately since 1982, Isotretinoin was approved for the treatment of this pathology, when it is already serious and positive results were not achieved with other natural medicines , pills or ointments indicated for this purpose.

The Isotretinoin is a retinoid derived from the ” vitamin A ” and oral administration, thanks to its effectiveness must act on all the factors that help develop chronic acne in any area of ​​the body.

In addition, it is responsible for reducing and eliminating the closure of the pores due to the excess production of sebum and skin oil, it also has an anti-inflammatory action and a bactericidal agent that reduces any population of bacteria that may form in wounds, specifically wounds. of the genus ” Propionibacterium Acnes”.

It should be noted that this product is usually used when the acne problem is somewhat severe and of bacterial origin , because there is acne product of hormonal malfunction, so we proceed in another way with drugs that contain hormones, such as contraceptive pills in the case of women.

Check in this article  Severe Acne: Treatments, Pathologies, Symptoms and Causes.

Is isotretinoin for all types of acne?

Mainly we must know what are the types of acne that exist in order to know if Isotretinoin is appropriate:

Hormonal acne

Hormonal acne tends to appear at the stage where considerable hormonal changes occur in the body, such as: puberty, menstruation, pregnancy and pathologies such as polycystic ovaries, stress and other diseases.

The location of this type of acne is in more specific areas of the face, as well as the regions located below the cheekbones and along the jaw line, being more frequent in women with the presence of polycystic ovaries.

The symptoms of this type of acne are very annoying, because they are usually very deep, cystic and sensitive to the touch. Generally, there is usually a feeling of mild pain in the pore to the touch, even when no physical contact is made.

With this type of acne, special care is required, because it tends to leave a scar . It is generally resistant to anti-acne cream treatments.

Acne vulgaris

Acne vulgaris or common acne, is a skin condition that often occurs frequently in adolescence and is commonly known as pimples or pimples, it is a disease that can be severe but treatable.

This pathology occurs when the pilosebaceous units become inflamed, (including the hair follicles and the sebaceous glands) forming the characteristic papule or nodules in areas such as the face and the upper part of the trunk. If you manage to remove its contents, this papule can leave a scar or stain in the area.

In general, acne occurs due to hormonal problems, however, common acne cases are about a high production of sebum and oil in the skin .

Acne can be hereditary, which predisposes the body to be more likely to suffer from this condition at some stage in your life.

Here you can learn more about the topic  Seborrheic Acne: Treatments, Diet, Pathology, Causes and Symptoms

Recommended dose of Isotretinoin

The dose to be administered will depend on the weight of the patient or affected person and the severity of the disease . In a high-dose treatment, 0.05 mg / kg per day is supplied, reaching up to 2 mg of Isotretinoin per day for a total treatment of 6 months.

If the case of acne is very severe, the doctor will indicate to continue the treatment for 8 more weeks, after the initial treatment.

Isotretinoin can be found in different forms, but the most common is found in the form of a pill or coated tablet, under the name of many commercial brands. Although you can also get the presentation for topical use prepared at 0.05%, with different trademark names.

Advantages of Isotretinoin

We can really say that the isotretinoin is effective for the treatment of severe acne, because it has a before and after referring to the cure of this skin disease. The majority of people who have used this product achieved a cure of almost 100% and without relapses.

This drug produces a rapid improvement in the first weeks of treatment, improving the appearance and inflammation of the papules, and generating a drastic reduction in the risk of relapsing the disease.

Another advantage is that while treatment with this drug is being carried out, it is not necessary to apply other therapies together to improve this skin pathology. The same effects that the tablet presentation produces are also offered by the topical presentation or in the form of an ointment.

In addition, it significantly improves the basal appearance of the skin , since it minimizes inflammation and makes it smoother and brighter with a rejuvenated appearance thanks to the presence of retinoids in its active compound. On the other hand, it removes excess sebum and oil from the skin and hair , eliminates excess shine in areas that produce high sebum production.

Check in this article  How to Take Care of Oily Skin and Dilated Pores

Disadvantages of Isotretinoin

The isotretinoin , to the like other drugs does adverse effects, with the advantage that can be detected in time by a series of blood tests to beginning, during and at the end of treatment.

Because it is characterized as a strong drug, its use is highly regulated which makes it a safe therapy .

Side effects of Isotretinoin administration

Let’s take a detailed look at each of the possible side effects of Isotretinoin administration.

Xerosis (dry skin and mucous membranes)

It occurs because Isotretinoin works by significantly eliminating sebum, making the skin dry, being more noticeable on the lips, nasal mucosa and the back of the hands; It is related to the administered dose of the drug and the duration of treatment, but fortunately it is reversible.

Congenital malformations

While taking this drug you cannot get pregnant during the period of time that this drug was prescribed, since you have a great chance that the fetus will suffer congenital malformations almost 45%. After stopping the treatment, you must wait at least 2 months to eliminate the excess medicine in the body.

Hepatotoxicity

Like all drugs, it is metabolized in the liver , so while the treatment is being taken, blood tests should be performed periodically to assess transaminases.

Isotretinoin in cream

The Isotretinoin is structured with ” vitamin A” , which regulates epithelial growth so its application acts as a cream stereoisomers and stimulates mitosis in the epidermis.

Combat the hyperkeratosis characteristic of acne vulgaris ; It helps the desquamation, expelling the annoying papules, preventing lesions and reactivating sebaceous production in a less excessive way, preventing the reappearance of lesions.

Check our article on  Cystic or Nodular Acne: Causes, Symptoms and Best Treatments for each type

The Isotretinoin cream has the same form anti – inflammatory effects caused by the migration of leukocytes to the affected area, action induced by a compound belonging to the “vitamin B4”. In these cases, it was found that Isotretinoin cream is more effective than Tretinoin .

Isotretinoin in pregnancy

This drug is ” teratogenic” which translates as; causing miscarriages and severe congenital malformations in the fetus.

That is why the use of both male and female barrier contraceptive methods is vitally important to avoid possible pregnancies during treatment. Also, this drug can significantly decrease the effects of birth control pills.

The doctor may indicate to sign a document proving that you have knowledge of these effects and will constantly request pregnancy tests throughout the treatment as a rule out.

Diabetes and Isotretinoin

Isotretinoin has as a contraindication for its use in people who suffer from Diabetes or have heredity of this disease.

Cases of lawsuits have been reported to Bayer and Roche laboratories for this type of adverse drug effects.

But, what happens in the body if you consume this type of medicine and you have Diabetes? ; This drug appears to interfere with blood glucose concentration and significantly increase plasma triglyceride levels, causing a significant decrease in DHL in the body, which can create an environment conducive to cardiovascular failure.

It is for this reason that you should be as clear as possible in a medical review in search of improving acne cases, because by ignoring any detail or pathology you can be immersed in a myriad of consequences that can become lethal.

Learn more about  Diabetes: Complications, Causes, the 6 Types and how to Prevent them

If you suffer from diabetes or have a heredity of suffering from this type of disease, the treating doctor should be notified, who will determine if it is necessary to carry out corresponding studies to assess said condition and evaluate if the treatment can be carried out or simply opt for other drugs.

It can occur with the use of Isotretinoin for a long time, the right environment for a person who does not have diabetes (but does inherit this disease) can develop it and after this there is no going back.

It is for this reason that any change that occurs in the body that will be subjected to long-term treatment with Isotretinoin must be notified , since this will determine the adverse effects that this drug may produce.

Not everything is the fault of the laboratories or the pharmacist who distributes this medicine , it can also influence the fact of hiding information about the true state of health just by following the indications and taking this medicine to improve the appearance of skin affected by acne .

Or failing in the indications of the treating physician, disrespecting the care that must be taken while using this medicine, such as, for example: the consumption of alcohol together with this medicine could lead to an increase in triglycerides in the body and a decrease in high-density protein or HDL concentrations, thus producing a cardiovascular risk.

This increase in triglycerides product of the ingestion of this medicine together with alcohol can lead to liver malfunction, which would not be induced directly by the medicine but by disobedience to the doctor’s instructions.

Cases like this, where the conditions to carry out the indications strictly as indicated by the doctor are not met, must be evaluated to guarantee in the first instance the desired effect of the drug on the skin and avoid consequences that could cause greater damage to the skin. Health.

The photosensitivity produced by Isotretinoin

As is well known, photosensitivity is a skin allergy caused by sunlight , it can be caused by prolonged exposure to sunlight or simply by the use of chemicals on the skin that react negatively in the presence of the Sun.

In the case of photosensitivity due to the use of Isotretinoin , symptoms will appear after 2 or 3 hours after exposure to sunlight. They usually go away or get better after 24 hours.

To alleviate the symptoms, you can apply a cold cloth or compress to the affected area and spray cold water frequently, in addition to preventing another similar inconvenience, you should use sunscreen with a screen greater than 30 SPF , of course, depending on the presentation of the Isotretinoin since it can also be in cream or gel.

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If you have severe pain, fever, butterfly-shaped rash and bruises, you should go to the doctor immediately to indicate the corresponding medication and , if necessary, temporarily suspend the use of Isotretinoin .

Hidden information about Isotretinoin

Isotretinoin is also known by the name Roacutan, from which the desired effect is obtained, that is, it eliminates acne, but with very annoying adverse effects, since it removes hydration from the skin, the lips crack and the mouth dries. .

The main producer of this drug has received lawsuits throughout the use of the product, due to the risks that can occur with the use of this drug.

Among these lawsuits are results where it was ruled in favor of the plaintiff , cases like this happened in New Jersey (United States), for not making clear in the drug’s leaflet the main component such as Isotretinoin and the risk of suffering with the use of the drug inflammatory bowel disease, the product of which the plaintiffs claim that they currently suffer from ulcerative colitis.

The judgment in favor of the plaintiff is for a compensation sum of $ 18 million that Roche laboratory must pay.

It is not the only demand, there are many, but it seems that in people who have been affected by some of the risks of treatment with this drug, they have seen in favor more the benefits it has offered on the skin and aesthetics, compared to the damages that it has could cause in your body.

Due to these lawsuits, Roche withdrew the drug from the market in the United States in 2010 , with thousands of lawsuits still pending on this date.

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It is believed that Roche hides many of the adverse effects of this type of medicine from the world market , so the European Medicines Agency (EMA) awaits answers about the thousands of adverse effects that users who have used the medicine demand in the United States.

Likewise, there is great concern about the cases in which adverse reactions to this drug have led to death and which are said to be a high and unrecorded number.

All people have the right to know the adverse effects to which they will be subjected with the use of certain drugs, even if its use is to improve an important health condition.

Therefore, it is logical that lawsuits of this type are produced against the laboratories that manufacture and distribute these drugs, if the sequelae that occur in a certain organism are not found in the package insert.

This type of adverse effect, such as inflammation of the intestine, has a negative impact on the organism of great importance, because once the disease manifests itself, it is difficult for the person to recover.

In other words, they are life-long sequels. Then it is worth highlighting this question: Is the aesthetic appearance of the person worth more than life itself? It must be answered without quickly thinking that it is not.

Therefore, it is necessary to study the risks and benefits to determine if you agree to the use of this drug due to the effects it produces against diseases such as acne.

Isotretinoin interactions with other medications

Isotretinoin like other drugs of this type, can have interactions with other drugs.

Read the article we have on  Tetralysal: Contraindications, Properties and Benefits

In anticonvulsants or systemic corticosteroids or phenytoin and Isotretinoin

In the presence of these drugs, special care must be exercised, apparently one of the adverse effects of the combination of these drugs is the loss of bone mass with recurrent use.

Likewise, the metabolism of vitamin D in the body can be affected, so it can cause rickets.

ORAL CONTRACEPTIVES AND ISOTRETINOIN

Apparently this drug does not influence the action of the estrogen-based contraceptive or serum progesterone levels, even so, the doubt arises that Isotretinoin interferes with the effectiveness of contraceptives, decreasing it.

Due to the adverse effects that can appear during treatment and present a pregnancy, it is preferable not to take risks, so the most recommended in this case is the use of barrier contraceptives, both female and male, to avoid pregnancy.

In progestin-based oral contraceptives, Isotretinoin decreases its contraceptive efficacy, so pregnancy should be prevented with other methods or abstinence practiced during treatment.

THE USE OF VITAMIN A WITH ISOTRETINOIN

The use of two retinoids can produce vitamin A-induced toxicity or hypervitaminosis A, which can cause abdominal pain, mood swings, drowsiness, dizziness, or dizziness.

Also present in a more chronic way such as jaundice, loss of appetite, visual disturbances, alopecia, bone abnormalities and pain.

ORAL TETRACYCLINES AND ISOTRETINOIN

Isotretinoin has been associated with benign intracranial hypertension when it is administered in treatments together with tetracyclines , so its use together is totally contraindicated.

PHOTOSENSITIVE MEDICATIONS SUCH AS SULFONAMIDES AND THIAZIDE DIURETICS

Isotretinoin can increase the skin’s sensitivity to sunlight or ultraviolet light even after treatment is over. That is why when used in conjunction with these drugs that cause the same effect, they can cause a more severe reaction if the person is exposed to the sun.

Look here  UVA and UVB Radiation: The Importance of Sun Protection

In case of overdose with Isotretinoin the following should be taken into account

You should go immediately to a healthcare center and if possible take with you what was left of the presentation of the medicine, so that the health personnel determine the actions to follow corresponding to the ingested drug.

It is a situation that leads to a very life-threatening state of health , therefore everything will depend on how quickly you act after the drug overdose.

As a first instance in the hospital, the health personnel will proceed quickly to the gastric emptying, only if two hours have not passed since the excessive taking of the drug, that is why an interview of the facts with the greatest possible certainty is important.

The patient should be monitored in search of any increase in arterial and intracranial pressure, likewise, women of reproductive age under this condition should undergo a pregnancy test.

Blood tests should be performed to determine the presence of Isotretinoin in the blood and its active methanolites.

Health personnel must act together with toxicology personnel to determine with greater precision the actions to take in these types of circumstances, where the life of the person is highly compromised.

An overdose of the drug is not going to happen by chance , but by a series of signs that may be noticeable, such as changes in the person’s behavior, depression, lack of attention to daily tasks, among others; They can guide when something is wrong and act in time before an event of this magnitude occurs.

It is for this reason that the person must have a strict medical control , where their mental state will be evaluated in search of adverse effects of the drug such as depression or anxiety.

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Failure to comply with these precautions can lead to outcomes such as: overdose with the same medication due to the same imbalance that the person may be experiencing.

It is recommended that at the slightest change in the person’s behavior to go to the treating doctor and expose said condition or go to another specialist such as a psychologist, since together they can help to finish the treatment in the best way and with the expected results. which is to improve the appearance of the skin.

Important notes on the use of medicines like Isotretinoin

It is important to note that not everything that is prescribed by a doctor brings the absolute solution to a certain health problem, everything will depend on the reaction of the organism to which the drug is subjected, in addition to the care and monitoring of medical orders established for it.

In the case of Isotretinoin, much controversy has been caused and it has been the subject of many investigations, debates, and lawsuits against the pharmaceutical industry or laboratories that are responsible for their manufacture, for hiding important information about their adverse effects.

The cases of death not registered by the ingestion of this drug cause great concern and induce lawsuits, as is the case of an adolescent who began his treatment with this drug and due to the depressive effect caused by its administration, he committed suicide.

The father of this young man is called Liam Grant , who was concerned about inquiring about the adverse effects of this drug and alerting the pharmacovigilance authorities, this being the beginning of a long struggle.

The result was not encouraging, although he did gain access to the European Medicines Agency (EMA). Years ago in Denmark specifically in 2002, he had tried the same thing, but Roche blocked access for no financial loss.

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Cases like this lead to the question: How is a drug laboratory going to promote (by not having economic losses) the induction of death as an adverse effect of one of its drugs and not doing anything about it?

Likewise, it is reported that with the use of the drug there are changes in the behavior of people classified as anxiety , so it is not recommended in people who operate heavy machinery or drive, since it is considered that it can be harmful.

They are effects that are not mentioned in the drug leaflet , hence the fight and demand of these laboratories by people who have been subjected to this type of treatment and that have led to accidents or harmful changes in their behavior, without no apparent reason but taking this medication.

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Kathie Sand always saw the world of beauty as the terrain on which to build her professional career, a goal that was clear to her when she was only 15 years old. Her great concern to expand knowledge led her to settle in Paris where she studied hand in hand with the best beauty professionals and with the most advanced techniques for skin care.

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