Side Effects of Accutane: The Hidden Dangerous and Life Threatening Effects

(Last Updated On: August 3, 2018)

Having problem skin can be embarrassing and painful. If you are unfortunate enough to suffer from a skin complaint, you will know how arduous it is to find treatments and products that work for you. Acne is a common skin complaint which ranges from mild to severe, and it can make a sufferer feel self-conscious and embarrassed. It is most common in the teenage years as it is strongly linked to hormonal fluctuations, but it can occur at any age. What is acne and what causes it?

What is acne?          

Acne occurs when the oil-producing glands of the skin produce excess oil in response to hormonal fluctuations. Dead skin cells block the pores and this causes unsightly blackheads and whiteheads. The bacteria that causes acne is called Propionibacterium acnes and it lives on everybody’s skin. It is usually harmless, but hormonal sensitivities and a buildup of oil can cause inflammation in acne prone people.

Acne usually presents as a mixture of oily skin, blackheads, whiteheads, red spots, and pimples filled with pus. Cysts can also develop. It will usually appear on the face, neck, chest or back, where there are the most oil glands.

Self-help for acne

Healthy skin starts with a good skin care routine

Skin care

Healthy skin starts with a good skin care routine. You should cleanse your face twice daily and use an oil-free moisturiser. Avoid rubbing your face to vigorously as this can make irritation worse.

If you have inflamed acne, you should use an antibacterial cleanser which contains benzoyl peroxide. This chemical reduces excess oil and helps dead skin cells to shed. This stops the pores from being clogged up.

Choose oil-free makeup as this won’t clog pores.

Skin care and body acne

If you suffer from acne on your body as well as on your face, use a soft washcloth to clean your skin rather than anything abrasive like a loofah which can irritate the skin. Baths are better than showers as lying in the warm water will remove dead skin and open the pores. After you have cleansed your skin, apply an acne cream or lotion to the affected skin and wear loose cotton clothing to allow skin to breathe.

Male skin care and acne

A skin care routine is not just for girls. Men should also wash their face twice per day and use an oil-free moisturiser. Don’t wash the face more frequently than twice per day as this can strip the skin of its natural oils and cause irritation.

Avoid washing your face too vigorously as this can remove natural oils from the skin as well as irritating your acne. It is easy to assume that the more you scrub your face the better, but it can have an undesirable effect.

Using an electric razor rather than a manual razor and try to avoid catching it on the spots. Avoid shaving if your acne is severely inflamed.

Other self-help methods

Try and eat a healthy diet. There is no evidence to suggest that acne is caused by fatty foods like chocolate and chips but it may aggravate it. Having an adequate nutrient intake will promote skin healing, as will ensuring you drink plenty of water.

Try to reduce stress in your life. Stress can cause hormonal imbalances, and hormonal triggers are a common cause of an acne outbreak.

Don’t squeeze or pick at spots. This can be tempting but it can cause infection and scarring which might be permanent.

How is acne treated?           

There are over the counter products available, though if your acne is more severe, these will probably not be effective for you. If you visit your doctor, you will most likely be prescribed one of the following treatments:

Topical treatments

These are usually the first line of treatment for mild to moderate acne. They should be applied to the affected skin up to twice daily. Topical treatments currently available include benzoyl peroxide and nicotinamide.

Antibiotics    

These are usually used alongside a topical treatment. Drugs like tetracycline are commonly prescribed for infected acne, and are usually taken for at least 2 months to ensure any infection has cleared.

Oral contraceptive pills

Some contraceptives can reduce the skin’s oil production, though it might take a few months for it to have a positive effect on your acne.

Retinoids

These are a powerful and effective treatment for acne but they can cause some serious side effects. You must be under the supervision of a dermatologist when using this treatment. It can cause harm to unborn children, and there are concerns that depression and suicidal feelings have been noted by people using the treatment.

Other treatments

Moderate acne can be treated using laser or light therapy, however this does not appear to be effective for more severe forms of acne.

Natural ways to fight acne

There are some natural ways to fight acne which you can use alongside conventional treatments. These natural treatments are gentle on your skin and on your system, and better still, they are ingredients that you probably already have in your kitchen cupboards.

Apple cider vinegar

Apple cider vinegar is antibacterial and antiseptic, so it helps cleanse the pores of oil and the bacteria that causes acne. The vinegar restores the skin’s pH balance too.

Mix 1 teaspoon of apple cider vinegar with 2 to 3 teaspoons of filtered or distilled water. Apply this to the skin using a piece of cotton wool. Leave it on the skin for 10 minutes then rinse it off with warm water. Repeat twice per day for a few days.

You can also add a teaspoon of the vinegar to warm water. Drinking this twice per day is effective for people who are prone to acne.

Baking soda

Baking soda, or sodium bicarbonate is an antiseptic and anti-inflammatory agent. It helps to reduce the symptoms of acne and corrects the skin’s pH balance.

Mix 1 teaspoon of baking soda with water to make a paste. Apply it to the affected skin with cotton wool, then rinse it off. Use this remedy at least once per week.

Lemon

Lemon contains ascorbic acid, which is a natural astringent that dries out acne. Lemon also has antibacterial properties.

Apply lemon juice to the skin, leave it on for 10 minutes then rinse it off with cool water. Do this twice daily.

You can also make a solution of lemon juice and rose water. Mix it in equal amounts and apply to the skin with cotton wool. Leave it on for 15-30 minutes then rinse with cool water. Do this twice daily.

Drinking a glass of water with lemon juice is another way to keep your skin clear and healthy.

Use lemon with caution if you have sensitive skin.

Turmeric

Turmeric has antioxidant and anti-inflammatory properties which help reduce acne symptoms.

Mix 1 teaspoon of turmeric powder with water or rose water to make a paste. Apply it to the affected skin and allow it to dry. Rinse the paste off with cool water. Do this once or twice daily.

You can also make a face mask by mixing 1 teaspoon of turmeric powder with a teaspoon of honey and 2 teaspoons of plain yoghurt. Apply a layer to the face then leave it on for 30 minutes. Rinse off with cool water and use the mask twice per week.

Aloe vera

Aloe vera gel is effective treatment for mild to moderate acne. It contains a compound called saponin, which is an anti-inflammatory and antibacterial agent. This compound can help kill bacteria, reduce inflammation, and promote healing.

You can either apply the gel to the affected skin twice daily for one week, or you can blend a tablespoon of the gel with ½ teaspoon of honey and ½ teaspoon of turmeric, apply this to the skin for 20 minutes then wash off.

Coconut oil

The oil has antibacterial, antifungal, and antioxidant properties that can get rid of acne causing bacteria. Apply the oil to the affected skin before bed and wash it off in the morning.

You can also add 2-3 drops of tea tree oil to a teaspoon of coconut oil, apply this solution to the skin, then rinse off with warm water after 10 minutes. Repeat 2-3 times per day.

Oatmeal

Oatmeal absorbs oil and exfoliates the skin so it gets rid of dead skin cells that clog the pores and cause breakouts.

Mix 1 tablespoon of oatmeal with milk to make a paste. Splash your face with warm water to open your pores, then massage the mixture on to the affected areas of skin. Leave it on for 5 minutes before rinsing with warm water.

You can also cook half a cup of oatmeal in some water and mix in a tablespoon of honey. Apply it to the skin and leave it on for up to 20 minutes. Rinse it off with warm water.

Cucumber

Cucumber is soothing for the skin and it reduces inflammation. Extract some juice from a cucumber and put it in the fridge for 20 minutes. Apply it to the skin with cotton wool then wait for 15 minutes before rinsing it off. Repeat this twice per day for a few days.

Honey

Honey is a natural antibacterial agent. It helps to kill bacteria and reduces inflammation.

Apply a small amount of honey directly on the affected area of skin. Leave it on for 15 to 20 minutes. Rinse it off with warm water first, then splash the skin with cold water. Repeat this twice daily for one week.

You can also make up a mixture of honey and powdered nutmeg. Mix it up in equal amounts, apply to the affected skin then leave it on for 30 minutes before rinsing off with water. Use this daily for a few days.

Tomatoes

Tomatoes have astringent and antioxidant properties, so they reduce the skin’s oil production, reduce inflammation, and promote healing.

You can rub a slice of tomato on the affected skin for a few minutes then rinse with warm water. If your acne is severe, mix a tablespoon of tomato juice with lemon juice and ½ teaspoon of honey, apply to the affected skin, wait for a few minutes then rinse it off. Use this remedy daily for a few days.

Accutane: a not so gentle treatment for acne

A not so natural treatment for acne is the drug Accutane. It was hailed as a miracle by sufferers of severe acne when it was first licensed and it got rid of acne in 80% of people who were treated with it. However, it proved not to be the miracle it was supposed to be, when numerous reports of adverse effects from the drug began to emerge.

How does Accutane work?

Accutane is classed as a retinoid and its original indication was as a chemotherapy drug. It was found to treat acne which did not respond to antibiotics by controlling the skin’s oil production and inhibiting the growth of bacteria on the skin.

When taking Accutane, the acne may worsen before it improves, and there are common side effects including dry eyes and headaches. A course of the treatment usually lasts up to 20 weeks.

Side effects and dangers of Accutane

abnormalities after the drug was taken during pregnancy

Birth defects

Accutane was first prescribed in 1982, then a year later, there was a report of a baby born with abnormalities after the drug was taken during pregnancy. There were further reports of babies being born with cleft palates, missing ears, facial disfigurements, and problems with the nervous system.

This led to countries like England introducing tight rules about the use of Accutane by women who were of childbearing age. Prior to taking the drug, women had to agree to get an abortion if they became pregnant. The drug is toxic to unborn children even if the medication is handled, or the dust is breathed in.

Bowel problems

Early studies of Accutane were carried out on dogs, and it was found to cause gastric bleeding in the animals. An early human trial discovered that out of 523 participants, 21% experienced bowel problems.

Many patients have sued the manufacturer of the drug after it caused them to develop bowel conditions such as ulcerative colitis and crohn’s disease. Ulcerative colitis causes inflammation in the digestive tract and ulcers in the intestines and rectum. Crohn’s disease can cause bowel obstruction and ulceration in the digestive tract. These conditions can considerably affect quality of life and cause sufferers to experience rectal bleeding and vomiting, as well as other symptoms. Some sufferers go on to have surgery to remove some of their bowel.

Suicide

The use of Accutane has been linked to psychiatric problems. From its introduction in 1982 to 2000, there were hundreds of depression cases linked to the use of the drug, 37 suicides, and 110 hospitalisations for depression or suicidal behaviour. By 1998, the manufacturer added a warning to the label stating that there was a risk of developing a psychiatric disorder. The link between the use of the drug and the development of psychiatric disorders is not fully understood, and a definite proven link between Accutane use and depression has not been established. However, the drug did cause depression in people without any history of mental ill health.

Pancreatitis

Retinoids may cause pancreatitis which can be fatal. Warnings are given to be aware of the signs of pancreatic disease, such as severe stomach pains and persistent vomiting and to stop taking the medication immediately if these occur.

Bone loss

There are indications that retinoids can cause bone loss, especially in the elderly, growing children or in those who participate in contact sports.

There are less serious side effects of Accutane which are not life threatening but can be troublesome, including reduced night vision, photosensitivity, cracked and sore lips, nose bleeds, peeling skin, hair loss, bleeding gums, headaches, fatigue, slow healing of wounds, frequent colds, dry skin and eyes, and muscle aches.

Accutane lawsuits

There have been over 7000 lawsuits against the manufacturers of Accutane since it was first prescribed. Most of these have arisen due to people suffering bowel disease, people who have experienced birth defects, people who became depressed and people who attempted suicide after using the drug.

Final thoughts

Acne is an embarrassing and uncomfortable condition which at best causes a sufferer to be self-conscious. At worst, it can be debilitating when it is severe.

The first step is establishing a good basic skincare routine, then speaking to your doctor about possible treatments available to you. There are also self-help methods you can use and natural remedies to try which won’t cure the acne, but they can certainly reduce symptoms.

People who suffer from severe acne need a stronger treatment solution, and one of these is the retinoid Accutane. First hailed as a wonder drug, it soon became apparent that Accutane was not the miracle that was promised. Generic brands of the drug still exist though it has been discontinued in several countries due to the severity of its side effects.

Written by Irina Radosevic MD
Irina graduated from the University of Belgrade, School of Medicine as a Doctor of Medicine (MD) and spent over 3 years working in the Clinical Hospital Center Zvezdara, in the Department of Emergency Medicine. She also undertook a postgraduate in Cardiology from the same University and had previously worked for over a year as a Physician and Nutritionist Dietitian for the Fitness club Green Zone. She eventually left her chaotic but fulfilling job in the ER to pursue her passion of writing, travelling and mountain climbing which has included writing a first aid course for the alpine club of Belgrade. Irina currently works as a VA for PintMedia focusing on medical and travel writing. Feel free to connect with Irina on LinkedIn and FaceBook. Her CV can be seen here.