Oral Retinoids for Acne

For people looking for acne treatment, it is impossible not to have heard of retinoids.  These vitamin A derived medications have been popular and effective for quite some time now, over 20 years in fact.  Normally, it is the topical variety that dermatologists prescribe to patients.  With externally applied retinoids, mild to moderate cases of acne vulgaris are treated with success.  We all know however, that acne can be very stubborn and can get fairly out of hand.  For cases that show extensive outbreaks on the face and in other parts of the body, it is possible to administer oral retinioids.

There are different oral retinoids used in treating various skin diseases like psoriasis.  For acne, though, isotretinoin is the vitamin A derivative of choice.  Just like the topical variety, ingested isotretinoin works by helping clear the skin of its dead shell.  Excess keratin is exfoliated leaving pores open and less prone to acne.  Peeling dead skin is not its only function as well.  While retinoids do not kill propionibacterium acnes per se, by controlling sebum production bacteria are left without a nourishing source.  Eventually, these acne causing bacteria will perish.  The dual effect of this treatment method is what makes it highly effective in the disposal of acne.

This treatment is so effective that around 75 to 80 percent of patients are fully relieved of acne after one five month course of medication.  This may be a long time, but for people suffering from severe acne, the wait in the end is worth it.  Doctors normally prescribe two doses daily in this period.  Dosage size is normally determined by the weight of the person.  Once somebody is used to the medication, they say it is best to take 120 to 150 mg per kilo of body weight.  Also, it is advised to take one’s meds during meals, as the body absorbs the isotretinoin better.

Now there is a reason why oral retinoids are only used as a last resort for very persistent cases.  While the effects can be fantastic when successful, the side effects can be quite disturbing.  It is known that isotretinoin is considered a teratogen, meaning this drug causes abnormalities to fetuses.  During treatment, doctors will advise women to avoid pregnancy.  Pregnancy tests must also be done before and during treatment to make sure.  

While babies having severe birth defects is the number one concern, there are other unpleasant effects that may occur.  Patients have reported bleeding gums, dry skin, an increase in cholesterol, joint pain and nose bleeds.  These however go away when treatment reaches its conclusion.  There is one side effect that is not proven, but a number of oral retinoid users have complained of severe depression and even suicidal tendencies.  Due to these disturbing side effects, one must work very closely with his doctor.  Extra vitamin A should be avoided, as well as the acne antibiotic tetracycline, as the latter can cause brain swelling.  This may be a very effective treatment, but every precaution must be taken. 

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