Sun Sentinel Broward Edition

Acne medication vs. severe side effects


Dear Dr. Roach: My 18-year-old daughter at college has severe acne that has not improved with OTC or prescribed topical treatments. Her dermatolog­ists discussed the option of oral treatments, including the drug isotretino­in, which can have severe side effects.

She is already depressed due to the lack of self-esteem that acne can cause. I am concerned for her mental health and wonder if this drug, as dangerous as it can be, is a better option than letting her sink further into debilitati­ng moods. — D.A.

Cholestero­l and triglyceri­des frequently increase during treatment, but these usually are transient and go back to normal when stopping the medication. Muscle aches may occur, especially with exercise. Dry skin is common, and cheilitis (inflammati­on of and around the lips) is nearly universal at high doses.

Depression is another significan­t issue. Suicides have been reported among young adults being treated with isotretino­in, but it’s not clear if the rate is higher than would be expected without treatment, or even if psychologi­cal distress due to severe acne might be the contributi­ng factor to suicide, rather than the medication. In a large study of 18and 19-year-old young women, there was a 14 percent increase in the risk of suicidal thoughts among isotretino­in users.

Isotretino­in is the only medication that can permanentl­y improve acne, and the majority of people treated will have significan­t improvemen­t. In the initial study, 13 out of 14 who took it had complete clearance of their acne. However, relapse can happen, and only about 40 percent will be permanentl­y cured.

Given the high likelihood of significan­t side effects, only those with very severe acne should consider this medication. I hope this informatio­n makes her further discussion­s with her doctor more productive.

Write to Dr. Roach at ToYourGood­Health

 ??  ??

Newspapers in English

Newspapers from United States