Accutane Not Linked to Depression

17-year-old
Ashley Blizzard says, “Well they give you this big pink book,
and I’m pretty sure it’s probably the scariest part
of taking the whole medicine.”

The book is full of warnings: one being Accutane may cause depression.

Ashley has seen the headlines. A number of people taking the
acne drug have killed themselves.

Her mom Teresa says, “I had kind of been a little bit scared
off by all the press, and been a little nervous about it and that’s
why we really hadn’t done it before.”

Ashley was hesitant, but gave the drug a try. She says, “My
best friend had started it and she said, ‘It’s great.’”

Dr. Gregory Cox, a dermatologist in metro-Atlanta says Accutane
is effective at clearing acne. “It’s the closest thing
we have to a cure for acne. Patients take it for five months, and
at the end of five months they are essentially clear with a 75
percent chance that they won’t have a recurrence.”

According to new research in the Archives of Dermatology, Accutane
does not cause depression. In fact, many patients in the
study felt better.

Dr. Cox says, “I see patients that come in that are sad
and depressed and withdrawn, and we put them on Accutane and their
skin improves and they become a new person at the end of the course
of treatment.” Ashley says, “I have not felt one side
effect of being anywhere close to depression.”

Many dermatologists say the study supports what they’ve
seen in their patients. “In the 18 years I’ve been
in practice, I have maybe seen a handful of patients who I felt
that Accutane might have affected their mood,” says Dr. Cox. “The
vast majority is just the opposite, I think their mood improves.” Ashely
says, “I have more confidence, so I like it, and I would
recommend it to anyone.”

Experts say teens should stop taking Accutane if they feel depressed.
Those with a family history of depression should consult a psychiatrist
before taking the drug.

Accutane (isotretinoin) is an oral drug, usually taken once or twice a
day for 16 to 20 weeks. It has shown itself to be very effective for treating
the most serious and disfiguring types of acne, which had shown little or
no positive reaction to previous treatment protocols. Accutane helps to prevent
extensive scarring in acne patients. After 16 to 20 weeks of treatment with
isotretinoin, acne completely or almost completely goes away in most patients
(up to 90 percent). For some people, however, the acne will come back, and
they will need additional treatment with isotretinoin.

Patients should carefully consider the several disadvantages of
isotretinoin. The drug is not only expensive but is also linked to
some adverse effects that can be severe. According to the National
Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS),
possible known side effects can include:

• Inflammation of the lip and mucous membrane of the eye
• Dry mouth, nose, or skin and/or itching
• Nosebleeds
• Muscle aches
• Photosensitivity
• Decreased night vision
• Increased blood cholesterol, lipid, and triglyceride levels
• Abnormal liver enzymes

The most serious potential adverse effect of isotretinoin is that it
is teratogenic, which means it can cause birth defects in the developing
fetus of pregnant women who take the drug. Therefore, it is crucial
that women of childbearing age are not pregnant and do not get pregnant
while taking isotretinoin. Women must use an appropriate birth control
method for one month before therapy begins, during the entire course
of therapy, and for one1 full month after therapy stops. Women should
talk to their doctor about when it is safe to get pregnant once the
therapy with isotretinoin has stopped.

While acne is not contagious, several factors contribute
to a person’s risk of developing the skin disorder. Children’s
Hospital of Iowa cites the following risk factors for getting acne:

• Acne can affect people of any age, but it occurs most commonly
  in teens.
• Almost eight in every 10 teens get acne.
• If a parent had acne as a teen, his or her child has a greater
  chance of getting acne.
• Some girls get acne a few days before they get their period.
  It is caused by hormonal changes in the body.

If you discover that your teen has acne, the American Academy of
Dermatology suggests teaching your teen these guidelines for basic
treatment:

• Do NOT pop, squeeze or pick at acne. This behavior can make
  acne worse by spreading inflammation. Comedones (acne) should be
  removed only by an experienced health professional. With appropriate
  treatment, acne should go away without squeezing.
• Gently wash the face twice a day with a mild soap and pat dry.
  Vigorous washing and scrubbing can irritate your teen’s skin
  and make acne worse. It will not clear up acne on its own – the
  acne needs to be treated with appropriate acne products.
• Use “non-comedogenic” cosmetics and toiletries.
• Give the acne products enough time to do their job. Ask a dermatologist
  or pharmacist for more information about how long a particular
  product needs before the acne begins to clear up.
• Some acne products can increase the skin’s sensitivity
  to sunlight and ultraviolet light from tanning booths. Use protective
  clothing and sunscreens, and avoid tanning booths in any case.

It is also important to remind your teen that the following items
can make acne worse:

• Oil-based makeup, suntan oil, hair gels and sprays
• Stress
• Menstruation in girls
• Too much exposure to the sun
• Airborne grease
• Irritating clothing or sporting equipment

Consult a dermatologist if your teen’s acne is severe, with
cyst development or scarring, or if an acne problem does not improve
after two to three months of treatment with over-the-counter preparations.
According to the American Academy of Family Physicians, a dermatologist
may recommend antibiotics, which can be very effective for treating
acne. They can be taken by mouth or used on the skin in a lotion,
cream or gel.

Experts at Children’s Hospital of Iowa gives the following
tips to help your teen keep acne at bay:

• Gently wash your face twice a day with a mild soap and warm
  water.
• Take off all of your makeup before you go to bed.
• If you wear makeup, sunscreen or use lotion, use kinds that
  say “oil-free,” “non-comedogenic” or “nonacnegenic.” These
  kinds won’t clog your pores.
• If you wear hairspray, cover your face with your hand while
  you spray. Hair gels and hairspray can irritate your face if they
  are put near the hairline.
• Washing your hair helps keep oil away from your face.
• If you work at a place where lots of grease exists, like at
  a fast-food restaurant or a gas station, wash your face as soon
  as you get home.
• Wash your face after exercising.
• Mild cleansers, such as Cetaphil, Purpose and Neutrogena, can
  be used to wash the face. Antibacterial pads can also be used to
  clean the face.
• Exfoliating cleaners and scrubs can be used. The
  scrubs are like grainy creams that you spread on the skin. They
  remove the outer layer of the skin and open pores. Ask a doctor
  first. They may be too harsh for some skin.