In Dr Nelson’s experience it is very rare to not respond to isotretinoin. As long as the dose is correct and the patient is able to tolerate the side effects (dry lips and dry eyes being the most common). Isotretinoin is ideal for cystic acne effecting the face, chest and or back.
How long is a course?
Usually 4-6 months but some people need longer. Dr Nelson would recommend that you continue on treatment until you have been spot free for at least 2 months.
Does it make you depressed?
Isotretinoin is given to many young people with acne. Young people with acne are also prone to suffering with low mood. Consideration of the limited data available would suggest that the incidence of depression and suicide during isotretinoin therapy may be no greater than the background incidence. A causal relationship has not been demonstrated. The occurrence of an idiosyncratic reaction to isotretinoin producing major depression and suicidal ideation, as suggested by case studies, remains a possibility — although, if so, this would seem to be a relatively rare occurrence.
Will I need to be monitored?
Yes. Women of childbearing age should be counselled regarding the teratogenicity of the drug. This means that the drug would be extremely toxic to the fetus if a female patient were to become pregnant while on it. Once the drug is stopped it does not affect future pregnancies. Female patients are required (unless they can confirm thy are not at risk of falling pregnant) to enrol into the pregnancy prevention program. Monthly pregnancy tests are carried out prior to issuing any further medication. Dr Nelson will fully counsel you regarding the drug and also discuss other alternatives.