Acne Treatment with Oral Retinoid

Acne Treatment with Oral Retinoid

Retinoids are the derivatives of vitamin A which are widely in use for exterminating acne lesions. But most of the over-the-counter and prescribed medications including topical retinoids are found to be ineffective for severe acne conditions. To alleviate harsh acne conditions dermatologists often prescribe oral treatments alongside some topical preparations. Among these medications the oral retinoid is certainly the cream of the crop.

What it is

Oral retinoid or better known as isotretinoin or 13-cis-retinoic acid is a potent systemic drug which has been in use for severe acne for decades. It is a synthetic derivative of vitamin A and extremely effective in clearing off cystic acne while other treatments fail to restore the normal healthy skin. It has been revealed through a study that 69 to 75 percent of women, who have successfully undergone isotretinoin treatment, got back their normal acne-free skin or the number of acne breakouts has significantly diminished. This medicine is most often commercialized under the brands of Sotret, Claravis, and Amnesteem.  Before you have decided to take the plunge, it would be always fruitful to be well aware of the ins and outs of the oral retinoid treatment procedure.

How Isotretinoin Works


For years isotretinoin has been used to palliate inflammatory cystic acne conditions. It mainly acts in three different ways which work along the same lines to cut back sebum secretion, comedone formation, and breeding of acne-causing bacteria called Propionibacterium acnes.

As a first step in the process of acne treatment, this medication significantly downsizes the sebaceous gland minimizing the sebum (body oil) secretion. Second, this oral retinoid works as an anti-microbial agent and puts an end to the P. acnes proliferation on the skin surface as well as deep inside the hair follicle. Thus this medication efficiently soothes the inflammation inside acne cysts and jammed pores. Third, it normalizes the differentiation of the keratin producing epidermal cells inside hair follicles, which suppresses the shedding of dead cells, preventing acne breakouts. Isotretinoin is that universally acclaimed rare medication which could take care of all of the pathogenic factors of acne formation giving you a relief from this tormenting skin disorder.

Course of Treatment

In general oral retinoid is prescribed with a treatment course of 16 to 20 weeks. Most of the patients start with a dose of 20 to 40 mg per day which changes to 40 to 80 mg per day over a period of time. Usually within 2 to 4 weeks patients could observe noticeable positive changes in their pustules and cysts. Although a single course of treatment for 6 months is found to be sufficient for most of the patients, it is advisable to continue with a low dose treatment to get the optimal result.

It has been found that the acne condition might relapse after the 6 month treatment course in the patients who are either teenagers having severe body acne or adult women. These patients should undergo multiple treatment courses of oral retinoid over a longer period of time.

Major Side Effects

Before prescribing isotretinoin one skin specialist must judge the associated risk factors for the patients. There are numerous side effects involved with this systemic therapy. Two most prominent side effects which have been faced by maximum patients are teratogenicity and psychological effects.

Being a potent teratogen, this oral retinoid has enormous effect over pregnant women. This leads to spontaneous miscarriage and severe birth defects in unborn babies if any woman takes this drug during her pregnancy. Through a study it has been found that 50% of the pregnant women who consumed this drug during pregnancy period end up with abortion and 25% of the rest have given birth to babies with physical abnormalities. Therefore it is highly essential that every female acne patients of child bearing age should undergo two pregnancy tests before they are prescribed with this medicine. Birth control pills are often prescribed along with istretinoin to avoid any future incidence of preganancy.

This oral retinoid is found to have profound psychological impacts over the patients. These include psychological disorders like depression, suicidal tendencies, and irritated behavior. Hence acne patients who are consuming isotretinoin should keep in touch with physicians and counselors to deal with such events.

Minor Side Effects


Treatment with isotretinoin might cause dryness of the lips which is known as mucocutaneous side effect. Other side effects include skin flaking, drying of nasal passage, thin hair, photosensitivity and fatigue. To avoid dryness lip balms are found to be quite useful.

Last Words

Despite several side effects oral retinoid has been established as a successful and viable acne treatment. As most of the side effects are endurable and curable, a planned way of treatment with isotretinoin could definitely bestow with a stunning skin.

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