Accutane Relapse: How Often It Occurs? What Are The Options?
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The success of Accutane has its dark side. Understandably, three decades of treating severe acne often becomes a target. Accutane relapse occurs in up to 60% of the patients who have taken it to deal with acne.
It is a highly effective treatment for severe acne. Almost every user taking a full course of the treatment has achieved a total clearance. Additionally, up to 80% of the patients remained acne-free with just a single course of it.
Table of Contents
A Short Note On Accutane
It contains a potent Vitamin A derivative which they call Isotretinoin. One of the most powerful acne medications available till date, it treats severe acne that does not go away with oral or topical antibiotics.
Isotretinoin is a member of chemicals known as “retinoids.” One has to take the capsules of Accutane only under a doctor’s prescription.
What Accutane Relapse Is
Accutane relapse refers to a condition where the severe acne, once clear, comes back. This may occur once one completes course of the therapy.
Various studies have attempted to explore the exact mechanism behind Accutane relapse. But only to end up as a failure. For this reason, the causes remain a mystery.
However, new studies have shed light on two factors that may play a contributory role in the relapse. The highlights of the studies are:
Food Habit Could Be One Of The Reasons Why One Has Accutane Relapse
Notably, the relation between the food intake and gastric absorption of Accutane is well established. Put it simply, for better absorption, take it with a high-fat meal.
In fact, the role of food in the safety and effectiveness of Accutane may be way higher than what we previously knew. Recent studies suggest that a high-fat meal can increase its absorption in the digestive tract by as much as three times. The Journal of Clinical and Aesthetic Dermatology, 2012. “Face to Face with Oral Isotretinoin.”
Taking Lower Doses May Make One More Prone
The ideal dosing is largely unknown.
However, most clinicians agree that the normal dosage is 0.5 to 1.0 mg/kg/day in two divided doses with food. The treatment usually lasts for 15 to 20 weeks. Nevertheless, they may adjust the doses depending on how one responds to it.
Additionally, if the acne persists even after the first course of the therapy. One may have to take a second course. Notably, there should be a gap of at least two months between the first and second courses.
Studies have linked the intake of low Accutane doses to an increased risk of relapse.
For this reason, a doctor may ask to take a high dose of it. Worried about the side effects of Accutane? The researchers say there is no significant difference in the incidence of side effects between the low dose and high dose groups. JAMA Dermatology, 2013. “High-dose isotretinoin treatment and the rate of retrial, relapse, and adverse effects in patients with acne vulgaris.”
Measures To Prevent Relapse
Accutane relapse is lower in the patients who take maintenance therapy with retinoid creams. For men, they take antiandrogen, while for women they take cyproterone and spironolactone.
Common Treatment Approaches After One Has Accutane Relapse
Commonly, they use three treatment approaches to treat the relapsing acne. They include:
- Topical retinoids: They may ask to apply a topical retinoid (for example Retin-A topical) over the affected areas once completing the first course. Similar to Accutane, topical retinoids are also very powerful. Therefore, exercise precautions to lower the risk of complications.
- Oral antibiotics plus topical retinoids: Under a doctor’s prescription, one may also start taking Tetracycline or Minocycline in addition to applying topical retinoids.
- The second course of Accutane: After a gap of at least two months, they may start a second course of the Accutane therapy.
What New Studies Suggest About Accutane Relapse?
Recurring acne can be really painful. Additionally, mood will reach a new low. Especially, when the most successful treatment (Accutane) shows the signs of a failure.
All things considered, it’s a better idea to stay updated with what’s going on regarding this wonderful acne medication.
- Accutane is very effective in clearing the severe acne. Moreover, it also extends the remission period. Factors like age, type of acne, and smoking habits may play a role in the relapse. In future, we can expect it to become a potential treatment for aging skin and other related conditions. The Australasian Journal of Dermatology, 2013. “Isotretinoin: dose, duration, and relapse. What do 30 years of usage tell us?”
- The rate of relapse may be lowered with topical retinoids and antiandrogen treatments. Actas Dermo-Sifiliograficas, 2013. “Acne relapse rate and predictors of relapse following treatment with oral isotretinoin.”
Severe acne is both a cosmetic as well as a health issue. Following an apparently successful treatment, it may come back again when Accutane leaves one’s system.
Nevertheless, Accutane remains the most preferred treatment for severe acne. Using it properly is very important. It is because a wrong use may lead to some very dangerous complications. This is of immense importance if a patient is a woman of childbearing age.
NEVER use it if one is pregnant or planning to become pregnant. One has to sign a document as a part of the iPLEDGE program before the start of the therapy.
Talk to a doctor to learn more about the treatment for severe acne and relapse or to find out the price of Accutane.
- Bauer LB, Ornelas JN, Elston DM, Alikhan A. Isotretinoin: controversies, facts, and recommendations. Expert Rev Clin Pharmacol. 2016 Nov;9(11):1435-1442. https://www.tandfonline.com/doi/abs/10.1080/17512433.2016.1213629?journalCode=ierj20
- Lee YH, Scharnitz TP, Muscat J, Chen A, Gupta-Elera G, Kirby JS. Laboratory Monitoring During Isotretinoin Therapy for Acne: A Systematic Review and Meta-analysis. JAMA Dermatol. 2016 Jan;152(1):35-44. https://jamanetwork.com/journals/jamadermatology/fullarticle/2471551
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