$Unique_ID{BRK00789}
$Pretitle{Skin and Subcutaneous Tissue}
$Title{Acutane for Treating and Clearing Acne}
$Subject{acne treatment medication}
$Volume{L-20}
$Log{}

Copyright (c) 1991   Tribune Media Services, Inc.


Acutane for Treating and Clearing Acne


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QUESTION:  I have acne (boils) on my thighs, but mainly on my buttocks, yet my
face is clear.  I recently read an article that said that Accutane, a vitamin
A derived prescription drug, proved successful for treating and clearing these
lesions, but not without side effects.  Can you tell me more about this
medication and any concerns I should have by taking it?

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ANSWER:  My first problem is with your diagnosis of acne on the buttocks.
Acne is an inflammatory disease that affects the skin in areas where there is
hair growth, since the disease affects the glands at the base of each hair
which form a wax-like substance called "sebum."  Acne most always occurs on
the face, but is also common on the neck, chest, shoulders, and upper back.  I
suppose it could occur on the buttocks, but it would have to be considered
rare.  The medication you referred to is called "isotretinoin" (Accutane)
which is a synthetic derivative of vitamin A.  It is specifically indicated
for cystic acne that does not respond to other therapies such as antibiotics
and local lotions or gels such as benzoyl peroxide.  Isotretinoin is
administered by the oral route and capsules are taken on a daily basis for
from 15 to 20 weeks.  There are some important side effects with this
medication and it must never be given to women who are pregnant or who might
become pregnant during the course of treatment.  Fertile women must observe
strict birth control measures during the period of time they are on the
medication for the danger of harming the fetus is a very real one,
particularly in the first three months of gestation The medication is also
prohibited in lactating mothers.
     Constant laboratory testing is necessary during the course of treatment
and must include liver function tests, as well as tests for serum cholesterol
and triglycerides.  Frequently, there is an increase of fatty substances in
the blood during treatment and if they reach extremely high levels, then the
medication must be stopped because of the risk of acute pancreatitis.
     Another possible consideration for the treatment of acne would be
"tretinoin" (Retin-A) from the same chemical family.  It is prepared as a
gel, cream or lotion and is applied locally.  Many adverse side effects are
therefore avoided.  However the medication can cause skin irritation in
sensitive individuals.
     In your particular case, however, I think I'd have another physician take
a look at your rash as the possibility that it might be folliculitis is a very
real one.  This is also an inflammation of hair follicles and a small pustule
or pimple containing pus may form around the opening of each affected hair.
In this case, proper treatment will include a local antibiotic ointment, or,
in the case of severe disease, an injection with either penicillin or
erythromycin.
     In any case, you will really have to visit your physician again as either
isotretinoin or tretinoin may only be prescribed by a physician and care
should be closely monitored during the period you are using the medication.
     The good news is that if you do have acne, and if your physician does
prescribe on of these medication for you, the hopes that you will have a
positive outcome are very high.
ÿ
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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
