Acne in Men
According to research, a large majority of people (up to 80% of all Americans) suffer from acne at some point in their lives. It goes away on its own for most of us, locked away and forgotten along with other horrors of teenagehood. Unfortunately, the rest of us aren’t as lucky.
Acne can be painful and both physically and emotionally damaging and can lead to problems such as permanent skin scarring and low self-confidence. Whiteheads, blackheads, papules (red spots under the skin’s surface), pustules (infected, pus-filled pores in the skin), nodules, and cysts (inflamed, swollen, and painful lumps under the skin) are all types of acne. You can have more than one type of acne, and your acne can range in severity. For example, whiteheads and blackheads are milder forms of acne, while nodules and cysts are more severe forms of acne that may require dermatologist intervention.
While most acne is hormonal and most common in teenagers, adult acne is far from rare. Adult acne is a significant concern and source of insecurity for many men and is not talked about nearly enough. Men commonly get acne on their face and back, which is more long-lasting than women. Facial acne breakouts also tend to be more severe in men. So while all men may not chase glassy skin that looks airbrushed, treating acne is a priority for men who suffer from it. The good news is that there are treatments that can help.
There is no magic bullet for acne, no surefire way of eliminating the problem. However, Accutane comes pretty close, especially when other treatments have failed. So what is this miracle drug? What does Accutane do? Does it really work, and can it be used by men suffering from acne? Is it safe? Keep reading to find out the answers to all your Accutane-related questions and find out if it’s something you should consider as an acne treatment.
Disclaimer: This guide cannot be used in place of medical advice, diagnosis, or treatment.
What Is Accutane?
Accutane is the brand name for isotretinoin, a retinoid or derivative of vitamin A. It is considered a ‘last resort’ treatment for severe acne. Accutane was discontinued in 2009, but generic versions of isotretinoin are still available on the market, and Accutane has now become synonymous with isotretinoin. Don’t be worried if you’re prescribed one of these generic versions- these drugs can do what Accutane does. They have the same chemical formula, mode of action, performance, effectiveness, and potential side effects as Accutane.
Amnesteem, Claravis, RoAccutane, Sotret, Myorisan, and Zenatane, among others, are popular isotretinoin drugs. They are available in the form of capsules that are orally administered to help manage severe nodular or cystic acne that isn’t improving with antibiotic treatments or topical medications. However, it should be noted that Accutane is only available with a prescription from a licensed dermatologist.
How Does Accutane Work?
To answer the question, what does Accutane do, we must understand what causes acne. As said earlier, acne is mostly hormonal. There is a lot of misconception surrounding acne and diet, but it is safe to say that your breakouts aren’t caused directly by eating oily or sugary food (though poor diets can lead to hormonal imbalances which in turn cause acne).
Our skin has pores, each with a follicle that is made up of a hair and sebaceous (oil) gland. The sebaceous gland produces oil (or sebum) that travels up the hair and onto the skin, lubricating and protecting it. However, when sebaceous glands produce too much oil, you can get pimples or acne. Sebum and dead skin cells can also clog pores on the skin and become a breeding ground for acne-causing bacteria. So what does Accutane do to help?
One of the reasons isotretinoin is such an effective treatment is that it targets all of the underlying causes of acne. For example, antibiotic treatments can combat the bacteria causing the inflammation but don’t help much in reducing oil or sebum production. So if your acne is caused by overactive sebaceous glands, you might not see improvement. However, Accutane, or isotretinoin, addresses both of these and more.
Accutane improves cell turnover, decreases skin oil production, reduces inflammation, and decreases the number of P. acnes bacteria on the skin and in sebaceous glands. Isotretinoin works by shrinking the sebaceous glands in the skin, reducing the amount of oil they produce. Decreased oil production translates to fewer oil-clogging pores and fewer acne breakouts.
The best part of what Accutane does is that the effects aren’t temporary. The majority of patients who try a treatment with isotretinoin see a lasting improvement in their skin, persisting even after discontinued treatment. Some people have even reported a reduction in their acne scars as a result of the treatment.
Isotretinoin capsules are taken by mouth once or twice a day over the span of 16-24 weeks, which constitutes one round of treatment. Most patients see permanent improvement after one round, though some will have to undergo two rounds (with a two-month gap between rounds) to get the full benefit of the drug.
Your dosage of isotretinoin depends on your body weight and your response to the treatment. Your dermatologist will likely start with a low dose and gradually increase it after several weeks if your acne doesn’t respond. If, on the other hand, you experience a lot of side effects, your doctor will reduce your dose or instruct you to stop taking the medicine. The starting dose is typically 0.5-1 mg/kg of body weight per day. Accutane or isotretinoin capsules should be swallowed whole with a glass of water and taken with a meal for maximum efficacy.
Who is Accutane For?
Accutane, or isotretinoin, is FDA approved for individuals over the age of 12 who have moderate to severe acne that haven’t responded to other treatments. However, treatment with isotretinoin is not limited to teenagers and adults with severe acne, though the primary indication is for these patients. Doctors may also use Accutane to treat certain cases of psoriasis, rosacea, lupus, and certain skin cancers, or to prevent some types of cancer.
However, isotretinoin capsules should not be used by people who:
- Are allergic to isotretinoin or Soya (the capsules contain Soya)
- Have had reactions to other medicines in the past
- Have a disorder such as fructose intolerance (the capsules contain sorbitol)
- Have a history of mental illness such as depression
- Have liver or kidney disease
- Have high levels of cholesterol, other fats, or vitamin A
- Have ulcerative colitis or Crohn’s disease
- Are pregnant or breastfeeding
- Think they might be pregnant
What Are the Side Effects of Accutane Treatments?
Before beginning your treatment of Accutane, your doctor will run a thorough blood test to make sure the medicine is suitable for you. Monitoring the consumer of isotretinoin is just as important as clearing them for using it. This is because doctors are required to check the effectiveness of the treatment while ensuring that no dangerous side effect is kicking in. With treatment as potent and effective as Accutane for severe acne, risk factors and side effects must be considered.
To understand why isotretinoin is not an over-the-counter medicine to treat acne and can only be prescribed by a specialist professional, what does Accutane do is important. Since it is a powerful drug that addresses all four leading causes of acne, from countering inflammation to regulating pore-clogging, it can cause many changes inside one’s body upon use. Furthermore, the fact that it is the last resort option where conventional, safer acne treatments are ineffective proves that Accutane is not a magic fix-all for clear skin.
Primarily, certain risk factors within the population prevent certain people from using Accutane or isotretinoin. In terms of age group, children below 12 years of age or those who have not gone through puberty cannot be prescribed Accutane. One other risk factor is an allergy to Soya, as isotretinoin contains it, and general allergic reactions to certain medicines are also relevant. People with fructose intolerance, a digestive disorder that is hereditary, are not suited to Accutane treatment. Certain health risks, such as kidney or liver disease, high cholesterol, or high vitamin A levels, should be intimated to the doctor so they can make an apt assessment of whether Accutane is the right treatment plan for you.
10% of all Accutane users experience some mild and common side effects once they start their treatment. This includes dry, cracked, sore, or red lips, and this dryness is also observed in the eyes, nose, and throat. Nose dryness can also sometimes lead to nosebleeds. General pains and aches may also occur in the form of headaches, body or joint aches, and tiredness. While on the Vitamin A-derived isotretinoin treatment, your skin’s sensitivity to sunlight increases and may cause reactions when exposed. Some people experience cold symptoms, while others see an increase in flushing and sweating after taking Accutane. In addition, one’s skin color and nail growth might change, or see hair growth or hair loss. It is crucial that your doctor remains updated with these side effects and their severity.
Now for the less common side effects experienced by less than 1 in 1000 people prescribed Accutane. The most prevalent out of these include increased cholesterol. Going back to what does Accutane do, one crucial effect is increasing the amount of fat and cholesterol in one’s blood. While a fluctuation itself is not too worrisome, risk factors play a role here as well. If you are a regular consumer of alcohol, obese or diabetic, this change can substantially affect your health. The continuous blood work during your treatment ensures your health is a priority in this case.
If you opt for the Accutane treatment plan, joint and muscle issues are likely, and rare cases can have severe long-term consequences. Pain, tenderness, tiredness, or soreness may occur not just in your bones but also in your muscles and ligaments. This side effect may debilitate you if you’re used to daily gym sessions or have a demanding physical exertion regimen. Consulting your doctor about managing pain symptoms and exercise can help counter this problem. New, intense back or joint pain is cause for concern, along with a broken bone. Accutane has been shown to slow or stunt long bone growth for teenagers, whose bones are growing. This is a sign of a permanent consequence and must be considered in a professional care setting.
Of lesser observed but still potential side effects, pressure on the brain is a dangerous consequence of Accutane. Due to this, symptoms like intense headaches, dizziness, blurred vision, nausea, and vomiting may occur. Severe side effects of isotretinoin prescription treatment include slow speech, numbness on one side or part of the body, seizures, or even stroke. Visual impairment, ringing in the ears, or difficulty hearing are also consequences of increased brain pressure. Other dangerous signs to look out for are stomach and chest pain, increased heartburn, and pain or difficulty in swallowing. Also, rectal bleeding, diarrhea, or dark-colored urine may be observed as a side effect.
Mental health problems are a frequent cause of concern when side effects of Accutane are discussed. Mood changes, particularly depressive or self-harming thoughts, may occur with isotretinoin consumption. In severe cases, people taking Accutane can experience depression, psychosis (a break from reality), or suicidal thoughts and ideation. Look out for depressive signs such as loss of interest in activities, irritability, low mood, and changes in sleep and eating. Get in touch with your doctor as soon as possible if you see these side effects developing.
To accommodate people prescribed isotretinoin and also spread awareness regarding what does Accutane do, iPLEDGE was launched. It is an online, digital risk management system that ensures that people considering an isotretinoin treatment plan and those on it provide informed consent to use it.
The FDA-approved program mainly focuses on preventing exposure of isotretinoin to fetuses. Serious harm is predicted if pregnant women take Accutane, as isotretinoin can cause many health issues in fetuses. This includes premature birth, physical and mental defects, and even death. As a standardization method, all people, not just women, must register with the iPLEDGE program to receive their prescriptions. With this systemic approach, all wholesale distributors at pharmacies are required to be registered with the database, along with all doctors who prescribe Accutane.
While it may seem like a hassle, the iPLEDGE program averts a considerable risk that isotretinoin consumption poses and allows a safe dispensing of the treatment to all those who need it. Since there are monthly follow-ups required before you can receive your next month’s prescription, your condition remains monitored. Any side effects or concerns you may experience after your initial prescription can be addressed during these visits, which is a valuable benefit.
How Do I Cope With The Side Effects?
Isotretinoin treatments may seem like a double-edged sword, considering what Accutane does for severe acne and the potential side effects. The obvious solution would be to discontinue the medication or find an alternative for the serious side effects mentioned. For relatively milder side effects that can be difficult to cope with for a beginner, there are management tips.
For dry skin and lips, a common side effect, you can amp up your moisturizing efforts to accommodate your skin. With the wide range of functioning of Accutane, your skin, be it on your face or lips, will have a noticeable change. To combat dryness, you can apply moisturizer more frequently and reapply lip balm whenever your lips feel chapped. There are medicated lip balms available that help with soreness as well. Sensitivity to the sun is also a concern for many men, especially those living in warmer climates or who have to deal with sun exposure. Sunscreen is an effective shield from this side effect, and a high factor sunscreen with a minimum SPF of 15 can be very helpful. Steering clear of sunbeds and sun lamps during your Accutane treatment is also important.
Dry eyes can also be treated with a visit to the optician or pharmacist. They can recommend suitable eye drops that specifically combat dryness. In addition, sugar-free sweets or gum have been really helpful for people who noticed a dry mouth and throat after starting their Accutane treatment. For dryness inside the nose that can cause nosebleeds, try applying a light layer of Vaseline on the inside of the nose. That can help ease the discomfort and dry pull inside the nose.
Finally, for your aching or painful joints and muscles, a reliable painkiller can significantly improve the quality of your day. Laying off strenuous exercise until your Accutane treatment is over is your best bet with dealing with this side effect if you experience it.
What Else Do I Need To Know?
Can isotretinoin worsen acne?
Acne may get worse at the beginning of isotretinoin treatment, but it usually gets resolved on its own in a few weeks. Acne lesions or bumps may become more inflamed or painful initially, though it is important to note that their quantity does not increase. Overall improvement in skin condition can be seen as early as a week after starting treatment.
Can I die from taking Accutane?
Current evidence suggests that you cannot die as a direct result of taking Accutane or isotretinoin.
There is no evidence to suggest that Accutane causes infertility in either men or women. However, women who are pregnant or trying to conceive should not take isotretinoin as it is harmful to fetuses. A small amount of isotretinoin may be present in the semen of men on the treatment, though there’s been no effect of it on conceived children.
Avoid alcohol as much as possible during treatment as it can damage your liver and increase cholesterol levels. If complete abstinence isn’t possible, don’t consume more than the recommended 14 units of alcohol per week. For reference, a pint of beer equates to 2 or 3 units of alcohol.
Unless specially instructed by your doctor, you should continue on your regular diet while taking isotretinoin.
You should not donate blood while on isotretinoin and at least one month after discontinuing treatment. This is to prevent the risk of donating blood to a pregnant woman and harming her baby.
Some medications, such as methotrexate and tetracycline antibiotics, may react adversely with isotretinoin. Therefore, it is essential to tell your dermatologist or pharmacist what medicines, herbal medications, and supplements you are taking before starting Accutane.
Do I need to take Accutane for the rest of my life?
You do not. Isotretinoin is completely removed from the body around two weeks after the last dose. However, the benefits of isotretinoin do not stop after discontinuing treatment. Lesions and discoloration from acne continue to decrease after treatment has stopped, and people see a permanent improvement in acne. Additionally, patients who have gone through a cycle of Accutane respond better to conventional acne treatments that their skin wasn’t responding to before.
Is Accutane Worth It?
Now that you have a fair idea of what does Accutane do, you should be able to make an informed decision with your dermatologist. You need to evaluate the pros and cons of using isotretinoin for your acne before starting a treatment. Accutane treatments are revolutionary, but they are associated with certain side effects and risks, which, no matter how unlikely, should give you food for thought. It should be said that most people who take isotretinoin report lasting positive results and do not experience anything beyond common side effects such as dry skin.
Even though Accutane is called a ‘last resort’ treatment because of its considerable potential side effects, it can be used as a first-line acne treatment. Your acne doesn’t have to be particularly severe for you to be considered for Accutane treatment. Sometimes, having acne that causes scarring or discoloration may qualify you for an Accutane prescription. However, this should be at the discretion of a professional. You should never self-prescribe isotretinoin.
All things considered, when taken under the careful monitoring of a specialist, Accutane is a viable and effective way of treating acne. Your acne-free clear skin days maybe a few isotretinoin capsules away! Talk to your dermatologist today to see if you qualify for the treatment.