Hailed as “the permanent cure for acne” and many times rightly so, Isotretinoin is available as Sotret (Ranbaxy), Isotroin (Cipla), Acctuane and other brands. Using Sotret for acne is becoming increasingly common in India.
Isotretinoin, a retinoid (a chemical relative of vitamin A) works by reducing oil secretion in the skin. It is seen as the only choice for severe, scarring, nodular acne. Accutane often works for acne when nothing else will.
What you should know is that this “permanent cure for acne” can come at a huge price. If you have a history of depression or are of sensitive disposition where you get rattled easily, Sotret may do more harm to your mind than any good it will to your body.
This is not to undermine the need for medicines like Sotret. We need them because sometimes that is the only thing that will work for acne.
For this post, we are going to refer to Isotretinoin as Sotret or Accutane (now discontinued) simply because these are two well known brands.
Side effects of Accutane
Not everyone may experience these side effects, but forewarned is forearmed. Take this – in 2009, Roche decided to pull Accutane off the US market after juries had awarded millions of dollars in damages to former Accutane users over inflammatory bowel disease claims.
- The most dangerous side effect is birth defects in an unborn child if pregnant women take Accutane. Even if there is a remote possibility that you might get pregnant or be pregnant already, Accutane is not worth the risk. Accutane is supposed to be gone from your system after a month of last dose. But who really knows how long the medicine will linger in your system. Paranoia would say that any residual Sotret could harm an unborn child.
- Anxiety, depression, suicidal thoughts, hallucinations. These side effects can range from a bad mood to full blown psychosis.
- Gastrointestinal bleeding, Inflammatory Bowel disease
- Liver toxicity due to Hypervitaminosis A
- Body ache, muscle pain
- Excessive hair loss
- Cannot donate blood for 1 month after your last dose.
- May affect your hearing and eyesight.
- Regular blood tests are needed to check for problems (not commonly done in India)
- Not really a permanent cure. Acne can come back after a year or so.
The side effects of Sotret are not limited to women of child bearing age. It can be harmful for men too. The side effects subside after stopping it, but not in everyone.
The U.S. National Library of Medicine website lists warnings and side effects of Isotretinoin consumption.
Irresponsible prescription of Sotret in India
Someone we know was prescribed Sotret even after they repeatedly told a big-name dermatologist that they had a history of depression. Perhaps read this Sotret Ranbaxy medication guide to get a better idea of how Sotret can wreck havoc on a person’s mental state.
Medical literature says that Accutane / Sotret should only be used as a last resort in acne treatment. Still, you come across accounts of men and women being prescribed Sotret by their dermatologists without exhausting other options first.
On the Internet, you find Indian dermatologists prescribing Sotret in online chat rooms calling it “just a vitamin a supplement” with “no side effects”.
Doctors may be the best judge, but they are not the best informers. It is not about how dangerous Sotret is. It is about how dermatologists don’t care enough to inform patients about the possible side effects of Sotret. Or take into account a patient’s mental and physical constitution.
We cannot label all dermatologists as irresponsible, but many are too rushed to care.
In countries like the U.S. and U.K., you can only get Accutane through prescription and even that process is carefully controlled. In India, it is generally a matter of walking up to your nearest medical store.
Should you take Sotret or not?
You have to weigh the psychological pressures (shame, self-loathing) of living with acne versus possible psychological (depression, suicidal thoughts, hallucinations) and physical (liver damage, birth-defects) side effects of Sotret.
You have to remember that the choice lies with you – not with your dermatologist.
There are healthy alternatives to Accutane. Keep an eye out for our future posts where we will tell you all about them.
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