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- $Unique_ID{BRK00789}
- $Pretitle{}
- $Title{Accutane for Treating and Clearing Acne}
- $Subject{acne boils inflammatory disease skin hair growth isotretinoin
- Accutane pregnancy pregnancies pregnant Fertile women liver function tests
- serum cholesterol triglycerides acute pancreatitis folliculitis inflammation
- hair follicles antibiotic ointment infertile infertility Fertility sterility
- sterile}
- $Volume{R-20}
- $Log{
- ACNE: Pimples and Pustules*0001102.scf}
-
- Copyright (c) 1991-92,1993 Tribune Media Services, Inc.
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- Accutane 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 waxlike 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 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 one of these medications for you, the hopes that you will have a
- positive outcome are very high.
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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.
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