Isotretinoin, marketed as Accutane in the US, is prescribed as a last resort in severe cases of acne. Accutane is a form of vitamin A, which lowers the amount of oil released by your skin, and also helps your skin renew itself more quickly. Accutane is used to treat bad cases of nodulocystic acne, mostly after other acne treatments have been tried without success. A course of Accutane in tablet form is an effective acne treatment, but the dangers of this acne medication are that it could cause serious side effects in the user.
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These include severe birth defects in developing foetuses, which is why FDA regulations insist women of childbearing age take two pregnancy tests before starting a course of isotretinoin. And also use two kinds of birth control for a month before therapy begins, during the treatment, and a month afterwards. It is also imperative that they don’t breast feed during this time.

And there are other possible side effects from taking isotretinoin – severe chest or abdominal pain, diarrhea, rectal bleeding, thinning hair and depression.

Oral contraceptives can also be used to cure acne in female patients by suppressing their overactive sebaceous glands. They can be used as long-term acne therapy, but should not be prescribed to women who smoke, have a blood-clotting disorder, are over 35, or suffer from migraine. While the new low dose contraceptive pills are much safer than earlier versions, they still present some risk to users.

Oral contraceptives work by targeting one of the four main causes of acne – excess sebum. Sebum is a natural oil which protects the skin against moisture loss, but which clogs pores when your body makes too much.

Dermatologists don’t usually prescribe an oral contraceptive until other acne medications have failed to work. Benzoyl peroxide and topical retinoids are usually the first treatments tried. Depending on the type and severity of the acne, an oral antibiotic can also be part of the treatment plan. If a woman’s acne does not respond to these treatments, an oral contraceptive may be the next step.

Spironolactone, a synthetic steroid, is sometimes used with oral contraception to treat acne in adult females. Prescribed off-label to treat hormonally influenced breakouts, Spironolactone is used as an acne treatment for women only.

This medication isn’t a first line of defense against acne breakouts, being effective only against acne caused by hormonal fluctuations. But it can be especially helpful for women with hormonal disorders which trigger acne. The side effects can include irregular periods, breast tenderness, headaches and tiredness.

Bottom line? Modern drug treatments for acne are effective, but carry their own risks. Do your due diligence before you try them – and make sure you carry out your doctor’s instructions to the letter regarding check-ups and possible pregnancy.