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- The experience of a nurses with isotretinoin: What do you need to know
When I was in my early twenty, I was fighting a serious and persistent case of acne. I had been involved in acne from my teens, but that was different. I noticed some improvement with a combination of local and oral antibiotics, but I was still pushing and worried about permanent scars. It was more than a skin theme. It influenced my trust and even my willingness to socialize with friends. After testing other treatments for a few months, my dermatologist recommended isotretinoin, better known as accutane. I was nervous after reading for treatment, but ended up changing for me. Now, as a nurse, I often walk patients through the journey I got years ago.
Whether you are thinking of isotretinoin for yourself or just want to understand what it includes, here is an overview of what to expect, based on both my professional knowledge and my personal experience.
What is isotretinoin and when is it prescribed?
Isotretinoin is a potent resin or vitamin A derivative that works with the permanent shrinkage of your sebaceous (oil) glands, reducing oil production and leading to long -term improvement in acne. It is intended for severe acne, especially when there are scars or when other treatment options (local creams combined with oral antibiotics). Occasionally, isotretinoin is used to treat other skin diseases at the discretion of the provider.
How soon can you start isotretinoin and how often will you see your dermatologist?
Because isotretinoin can cause severe genetic abnormalities if taken during pregnancy, all patients (men and women) must be enrolled in IPLEDGE® REMS program. It is a national safety program that regulates the use of isotretinoin to minimize fetal exposure. You will need to see your provider once a month to be confirmed in the iPledgeo and receive your re -half -time. In addition, if you can become pregnant, you should do a urine pregnancy test on every monthly visit.
- For patients assigned males at birth or females not dynamic in reproduction (eg, after a hysterectomy): You can start isotretinoin on the same day after the base line labs.
- For patients who may become pregnant: You will need two negative pregnancy tests one month before you start. You should use two forms of birth control throughout treatment and for a month after, as the drug will remain on your system. Acceptable forms of birth control include oral contraceptive pill, IUD, Nuvaring, hormonal implant, male condoms of latex and abstinence.
What will be the dosage and duration of your treatment?
Your provider will calculate the dose of isotretinoin based on your weight during your initial visit. Usually, the first month starts in half of the recommended maintenance dose to minimize the side effects, then it sometimes increases gradually but often the second month is doubled.
On average people complete their course in about 6 months, but your treatment could be greater or slightly smaller depending on the severity of your acne and the response to treatment.
When can you expect to see results?
Some lucky patients see improvement in their acne in the first month of treatment, but for most, notable changes come by the end of the third month.
What are the side effects of isotretinoin?
- Genetic abnormalities It can be very serious if she gets while she is pregnant.
- Increased flame of acneIt is referred to as “cleaning”, can occur in the first month of treatment and more often with very severe acne. To reduce this risk, our providers start low -dose patients.
- Dryness From lips, eyes, mouth, nose and skin expected.
- Higher photosensitivity or sensitivity to the sun It can lead to blisters solar burns if it is not diligent with the protection of the sun.
- JointsUsually mild and well -managed with daily stretching, increased hydration and a daily fish oil supplement.
- Other possible side effects Include but are not limited to mood changes, reduced night vision, headaches, fatigue. I ask my patients to inform me when they experience any of these other side effects.
How often will you need a workshop?
Because isotretinoin is able to increase triglycerides and liver enzymes (ALT/AST), you will probably have your laboratories to pull twice. Just as a basic line before you start the drug and once after the second or third month of treatment to make sure you tolerate your dose.
Can you drink alcohol while taking isotretinoin?
No, it is recommended to completely avoid alcohol. Isotretinoin and alcohol are both processed through the liver. Overall, they will increase the risk of pancreatitis and liver damage.
Can you take other medicines while in isotretinoin?
Your provider will surpass your medicine history to ensure that all your current medicines are compatible. But you must skip:
- Any medicines being processed through your liver like Tylenol
- Any supplements containing vitamin A
You should also stop all the active local ones used previously to treat your acne.
Useful supplements you can take during treatment
While there are many messages when using isotretinoin, here are some supplements we recommend.
- Antihistamines: Some providers advise daily antihistamines (such as zyrtec). Some studies Show that antihistamine can help reduce the risk and severity of initial cleaning and can also accelerate the improvement of acne lesions, while reducing the severity of certain side effects.
- Fish oil with omega 3: A daily dose of at least 1g of fish oil can help reduce side effects such as dryness and joint pains, absorption of isotretinoin help and lower triglyceride levels.
- Healthy fats: Avocado, olive oil, nuts, seeds and fatty fish taken at dose help to increase the absorption and efficacy of the drug.
When is the best time to start isotretinoin?
Technically, you can start isotretinoin at any time of year, as long as you are very diligent with sun protection. Ideally, I like to start my patients in autumn to avoid the Sun Peak era, as isotretinoin photosensitivity is very severe. The sun is also not kind to acne, another reason to avoid the sun!
For adolescents, it is ideal for completing the course of treatment before going to college, as ongoing monthly visits can be a challenge.
My personal favorite products while they are in isotretinoin
From my personal and professional experiences, here is the list of products that I like to share with my patients before starting their journey of isherinin.
- 32-40 oz water bottle: To ensure that they maintain well -hydrated that are extremely important
- Lips: Aquaphor Lip Protectant W/ SPF 30, Vaseline, Cortibalm by Dr. Dan, Eltamd UV Lip Balm
- Facial Cleaner & Moisturizing Cream: Cetaphil Gentle Skin Cleanser (Normal to Dry Skin), La Roche-Posay Abletiane Double Repair
- PROTECTION PROTECTION: Eltamd UV CLEAR SPF46 (on the face regardless of the season), La Roche-Posay Anthelios Melt-in Milk Orescreen SPF 60 (over hands all year and body when exposed to the sun)
- Daily House Moisturizing: La Roche-Posay Lipikar AP+M Triple Repair Moisturizing Cream, Cerave Moisturizing Cream (in the jar)
- For dry eyes/nose: Optical drops of lubrication of the system (avoid redness eyes such as Visine), nasal saline spray, aquaphor for nostrils and humidifier for sleep
- Extras when in the sun: Hat with wide hat, sunglasses, umbrella and UPF protective clothing
Looking back, starting isotretinoin was one of the best decisions I made for my skin and my self -esteem. The treatment required commitment and diligence, but it gave me constant results that local creams could never. I understand that the acne of the psychological impact may have and I like to help patients gain their trust back, is really changing life. The journey may be provocative at times, but the ultimate goal is worth it. If you are suffering from severe acne, book an appointment with me or one of my colleagues to see if you are a good candidate for isotretinoin.
