Isotretinoin Australia

Isotretinoin is a safe and effective way with proven results to effectively treat and eradicate acne. There are two groups who should avoid isotretinoin: Females planning a pregnancy and people who are depressed with suicidal tendencies.

Isotretinoin is absolutely unsafe in pregnancy. There is a very high risk of serious birth defects in a baby conceived during treatment, and for one month after treatment.

Any person is biologically capable of pregnancy must avoid pregnancy during treatment, either through guaranteed abstinence, or with effective contraception. Two forms (eg the oral contraceptive pill or intra-uterine device (IUD)) and condoms) of contraception are advised.

If contraception fails, termination/abortion of pregnancy may be advised, if pregnancy arises during treatment or within one month of cessation.

A general practitioner may provide emergency prescription contraception where appropriate, which prevents the majority of pregnancies if taken within 72 hours of intercourse.

There is no evidence of isotretinoin affecting male sperm or fertility.

After a female has completed isotretinoin and had one normal menstrual cycle thereafter, there is then no long term or delayed impact on her fertility or the health of future pregnancies.

It is not advised to breastfeed while taking isotretinoin.

The possible link between isotretinoin and mental health concerns, particularly depression and suicide, has been a topic of considerable discussion and debate for decades. Often patients and/or their families have heard of this query with isotretinoin, and naturally find it scary information to receive, especially if not provided in a broader context.

Because so many patients take isotretinoin, there will be a natural incidence of psychiatric disease in this very large group of patients. This incidence is not proof of cause. That is to say that a patient who becomes depressed while taking isotretinoin may have become depressed even if they did not take the isotretinoin.

While some studies may have previously suggested that isotretinoin may be linked to depression and suicide, the most reliable data and information that we have available at this time suggests no increased risk of suicide or psychiatric conditions among isotretinoin users at a population level. This data, in fact, suggests isotretinoin use is associated with a lower risk of suicide attempts at 2-4 years following treatment. This may be as a consequence of clearer skin and improved self esteem. In practice, clinicians often observe an improved mood during treatment for this reason.

It is important to avoid vitamin A supplements during treatment with isotretinoin.

Isotretinoin cannot be taken with tetracycline antibiotics (eg doxycycline).

Isotretinoin does not reduce the effectiveness of the contraceptive pill.

Mild headaches may be a side effect of isotretinoin. If these are mild, intermittent, lasting hours not days, and resolve with simple measures such as rest and paracetamol, then the medication may be continued. If headaches are frequent, raise this at your review, and see your general practitioner if concerned.

If headaches are severe, different to your normal headaches, last days, or are accompanied by tinnitus (ringing in the ears), blurry vision, poor balance), then treatment must be stopped immediately. Take no more isotretinoin medication. Contact acneRx, and also see your GP promptly.

A rare side effect of isotretinoin is intracranial hypertension (swelling on the brain). This is dangerous if treatment is continued. Urgent assessment and care at a hospital emergency is important, including review by an ophthalmologist to check for swelling at the back of the eye, due to pressure from swelling of the brain. Isotretinoin cannot be recommenced in the future if this diagnosis is confirmed.

Patients taking isotretinoin must consider themselves sensitive to easy burning in the sun, no matter what skin type they have, or how easily they normally burn. Life can still be lived, and time can still be spent outdoors, but all the normal 'sun safe' measures should be diligently followed. These include avoiding midday sun, when the UV index is high, wearing a hat, sunglasses, and protective clothing. Sunscreen should be applied regularly during the day, considering a chemical sunscreen as well as a zinc suncreen for high risk sites such as the face.

You may download the Cancer Council's SunSmart App here.

Isotretinoin may cause an increase in hairfall / hair shedding. This is called a telogen effluvium, and does NOT cause complete hair loss or baldness. Isotretinoin does not cause female or male pattern balding (androgenetic alopecia), or other forms of hair loss such as alopecia areata.

Isotretinoin can cause ingrown nails, usually the big toe nails. This is often dose related. Raise this concern as part of your review if you are concerned. Sometimes isotretinoin must be reduced to a low dose, ceased, or paused, to allow the skin around the nail to heal. Sometimes additional treatment with other medication is also required.

Dry lips are the most common side effect of treatment with isotretinoin. For most patients taking gentle or low doses of isotretinoin, this is mild, and easily managed with regular lip balm.

If dry lips become a concern, try applying lip balm hourly during the day. There is no 'best' lip balm. Everyone has a different favourite, and there is no need to spend a fortune on fancy products. It is the frequency of application that is important.

If your lips are peeling and cracking, the best time to gently remove these layers of skin is during your shower. At the end of your shower, use the length of your index finger to gently rub backwards and forwards on your lips, while the skin is soft from the water. This should encourage the layers of skin to roll off, without causing splitting or bleeding.

If your lips are sore and cracked despite the above, this will be discussed as part of your treatment review. Sometimes isotretinoin will need to be reduced, paused, or rarely ceased, due to dry lips.

While taking isotretinoin,a minority of patients develop a dry nose and even nose bleeds (epistaxis) from dry nasal mucosa.

Regular moisturisation of inside the nostrils is often enough to settle this down. Purchase a nose moisturiser from the pharmacy to use 2-3 times daily to manage this.

Lip balms or ointments such as liquid paraffin (Vaseline) are not suggested for use inside the nose on a long term basis, as they may build up over time in the lungs.

Infrequent, brief episodes of nose bleeds, which settle with pressure with tissues, are easily managed at home. Isotretinoin may need to be reduced to a low dose, paused or ceased, to allow the nasal mucosa to heal, and improve with regular moisturisation.

Any severe, or prolonged bleeding, which does not settle within a couple of minutes with pressure, requires urgent medical attention. See your GP urgently, or attend a hospital emergency department.

Isotretinoin is primarily used to treat severe acne, including cystic acne and hormonal acne, especially when other treatments like topical creams or prescription creams have not been effective.

It is still effective for mild acne, but if your condition is less serious, you can also explore topical creams or prescription creams.

Consulting with a specialist dermatologist like ACNE RX will help you determine the best treatment plan based on your acne severity.