Accutane: miracle acne drug or miserable medication?
All Carli Watkins wanted was to walk out of her apartment without putting on make up.
Severe acne covered her face all through high school and into college, so Watkins, a Holton senior, and her doctor searched for years for a cure to this problem and her personal embarrassment.
“I went through every pill, cream, face wash and lotion imaginable,” Watkins said. “Nothing was working. I felt dirty and like no one understood how hard I was trying to get rid of it.”
Nothing, that is, until her dermatologist decided to prescribe Accutane, the strongest acne medication on the market. Watkins said she had heard of the dangers but was so frustrated that she was willing to try anything.
Accutane, what some dermatologists have called the “miracle drug” of acne medicine, has serious side effects that have deterred some patients and left others wondering if the risks are worth it.
The medicine can cause joint inflammation, vision changes, sun sensitivity, hair loss, high cholesterol and blood pressure, birth defects in babies and possibly depression.
According to the FDA, Accutane, a medicine from Roche Laboratories that releases high dosages of vitamin A in the body, entered the market in 1982 to treat severe nodular acne. This type of acne forms large pimples on the skin and usually leaves large scars.
Dr. Matthew Buxton, dermatologist at Free State Dermatology in Lawrence, said Accutane is often a last resort medicine because it is so powerful.
“I usually go through other medicines with people before prescribing Accutane,” Buxton said. “Occasionally, though, I get someone with such severe acne or great scarring that I start them right away.”
Watkins went to her family doctor for more than four years, experimenting with nearly every acne product on the market. She said it was extremely frustrating to use multiple products and go through so much money for prescriptions with no results.
Andrew Jennings, Silver Lake junior, finished his cycle of Accutane in October. He suffered the same frustration as Carli.
“I’ve had acne since seventh or eighth grade,” Jennings said. “I had tried everything possible that was over-the-counter or prescribed by my doctor.”
Though Dr. Buxton said if taken properly, Accutane could be a safe medication, it’s a risky game for some acne patients.
“Everything on me was dry,” Watkins said. “My lips were unbelievably chapped, and the bottom of my feet cracked. When I first started taking it, my stomach hurt so badly, I couldn’t eat for a couple days.”
She said she also couldn’t wear contacts for weeks at a time because her eyes were too dry, and she lost interest in activities she once enjoyed, like volleyball.
“I just didn’t feel good—my skin was peeling, and I looked like crap,” Watkins said. “I just didn’t want to do anything or go anywhere.”
Jennings said dryness was his main side effect, also.
“My lips were chapped and hands were dry, and I started to get bloody noses pretty often,” Jennings said.
Female patients are the biggest concern to dermatologists, as Accutane causes serious birth defects or miscarriages. Roche takes these risks seriously and provides strict guidelines to women before they begin Accutane.
Shelley Rosenstock, executive director of public affairs at Roche, said women must take two pregnancy tests initially and one each month before being prescribed a new dosage of the medicine. She said women must also use two forms of birth control while on Accutane.
Accutane packets contain warning labels about side effects like birth defects. Perforated pull tabs, left, cover every Accutane pill and must be removed before the medicine can be consumed. Drawings like the deformed child appear on each packet to remind female patients of the risks of pregnancy.Photos: fda.gov
Watkins remembers being asked monthly if she could be pregnant and if she was using birth control.
While the FDA is ensuring that Roche adequately informs patients of pregnancy risks, the medicine has faced other criticism because of a possible link to depression.
Though the medical community is still at odds as to whether Accutane causes depression, the FDA reports that through 2005, 190 Accutane patients have committed suicide.
Dr. Buxton said he hasn’t seen a link between the two, and he was caught off-guard when Roche began adding labels to the medication that warned of depression.
“I don’t know if it’s just reports that have made people more aware of the risk,” Buxton said, “but people in their teens and twenties are the most likely to be depressed anyway.”
Watkins said she became more wary of the medicine when she had to sign a “huge packet of forms” stating she understood all of the dangers of Accutane, and her doctor asked her monthly about her mental state.
Jennings also had to take steps before beginning the medicine.
“I had to watch this movie that talked about all of the side effects, even though most of it was about getting pregnant,” Jennings said. “The doctor also warned me every time not to give Accutane to anybody else.”
Bill Axcell, pharmacist at Jayhawk Pharmacy, said the number of prescriptions for Accutane has declined recently, and he now fills only about two per month.
“I think people are finding out about all of the side effects with pregnancy and depression and the national registry with iPledge,” Axcell said.
The high price is also discouraging to some acne patients. Axcell said that without insurance, a 30-day supply of Accutane costs $550.
Carli Watkins is unsure if she take Accutane again, knowing everything she has been through. Her face is now clear, but getting to that point was painful and expensive.
“When you’re on it, you feel absolutely miserable,” Watkins said. “If I had known what all would happen, I don’t know if I’d be willing to go through it again if I had to.”
See pictures of two KU students who have recently taken Accutane.
Photos: Watkins and Jennings
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