Your doctor has decided to start you on a course of Isotretinoin for your bothersome acne. Good for you. Isotretinoin is one of the best medications available for the treatment of acne, especially if they are to leave marks and scars. Here are some tips so that you can get the best out of this medication:
(Do note that there are many brand names for Isotretinoin (the active ingredient) available in Singapore, such as Acnotin, Accutane, Roaccutane, Nimigen and Oratane but they are essentially the same medication.)
Isotretinoin takes a few weeks before your skin starts to feel less oily and congested. The frequency of new pimples forming should decrease gradually. If you are one of the minority who experience a flare/pimple outbreak at the beginning, do not despair, keep taking the medication and it will usually get better.
Do stick to the course of medication prescribed by your doctor. You will need to be on this medication for generally at least 6 months so that the effect is lasting after you stop taking the medication. Your attending doctor will tailor the course of medication according to your condition and body weight.
While isotretinoin is great for regulating dysfunctional oil glands in the skin, medical facials with a light chemical peel will help rid your skin of comedones (blackheads and whiteheads). This helps you achieve a clear complexion more quickly and reduces the risk of an acne outbreak.
Get your lip balm and moisturizers ready
One of the side effects that everyone will definitely experience is dry lips and dry skin. Keep your lip balm with you and apply it generously at least 3 times a day, especially at the corners of the lips. You should also apply a non-comedogenic moisturizer at least twice a day to areas of dry skin. With time, dryness gets better as your body gets used to the effect of the medication.
Take your medication after meals
Isotretinoin is a fat soluble medication, which means it is better absorbed into our body when there are fats present with it in our stomach. Do take the medication at the same time everyday, after a proper meal for best results. If you take it on an empty stomach, part of the medication is wasted as there are no fats to dissolve it to be better absorbed.
Sunscreen is your best friend
There is increased photosensitivity when you are taking isotretinoin, increasing your risk of sunburns if there is prolonged sun exposure. Applying a broad spectrum sunscreen when outdoors and avoiding unnecessary sun exposure such as avoiding suntanning will greatly reduce the risk of sunburns and developing post-inflammatory hyperpigmentation (darkening) of the acne marks and scars. Photosensitivity is increased only when taking the medication and goes back to normal upon completing the course of medication.
Use a mild cleanser
The use of a non-comedogenic, mild cleanser is recommended rather than using active cleansers which contain alpha- and beta-hydroxy acids such as salicylic acid as these may be too drying for the skin. Applying generous amounts of moisturizer after cleansing your face will further soothe the skin and reduce dryness.
Reduce your dose sensibly
If you are going on a beach vacation or doing outdoor activities in a dry climate country, do reduce the dose of the medication to half the dose or even less so that side effects such as dryness and photosensitivity are reduced. For example, if you are taking 1 pill of Acnotin 20 mg daily, you may reduce it to 1 pill every 2 to 3 days. Once you are back to your usual routine, increase it back to the dose originally prescribed by your doctor.
Contraceptives for ladies
Isotretinoin is a teratogenic medication, which means there is a high chance of causing birth deformities and spontaneous abortion for female patients should they get pregnant while they are taking the medication. It is imperative that sexual intercourse is protected and strict birth control is implemented for all female patients of child-bearing age, 1 month before, while taking and 1 month after stopping isotretinoin. There are no long term harmful effects on fertility or child-bearing, and female patients can resume family planning 1 month after stopping the last pill of isotretinoin.