NEW oral retinoid for acne (accutane, roccutane)

Isotretinoin (Roaccutane) is a retinoid used for the systemic treatment of nodul-cystic and conglobate acne and severe acne which has failed to respond to an adequate course of a systemic antimicrobial agent. It is also useful in women with acne developing in the third or fourth decades of life, since this late onset acne is frequently resistant to antibiotics.

Side-effects (mainly dose-related):
Dryness of skin (with scaling, thinning, erythema, pruritus), epidernal fragility (trauma may cause blistering), rarely acne fulminans, facial hyperpigmentation, dryness of nasal mucosa (with mild epistaxis), of pharyngeal mucosa (with hoarseness), of conjunctiva (sometimes conjunctivitis), decreased tolerance to contact lenses and rarely keratitis, visual disturbances (papilloedema, optic neuritis, corneal opacities, cataracts, decreased night vision, photophobia, blurred vision) - expert referral and consider withdrawal; hair thinning (reversible on withdrawal) or (rarely) hirsutism; nausea, headache, malaise, drowsiness, sweating, benign intracranial hypertension (avoid concomitant tetracyclines); myalgia and arthralgia; raised serum creatinine concentrations reported; raised liver anzymes (rarely jaundice and hepatitis); raised plasma triglycerides and cholesterol (risk of pancreatitis if triglycerides above 8 g/litre); allergic, vasculitis and granulomatous lesions reported, other side-effects reported include hearing deficiency, mood changes, convulsions, menstrual irregularities, hyperuricaemia, inflammatory bowel disease, paronychia and Gram-positive infections, bone changes.

From 'The Essential Guide to Cosmetic Laser Surgery':
If you have been treated with the anti-acne drug Accutane (Roaccutane - oral Isotretinoin), you may heal more slowly than the average patient and be at increased risk from scarring. Accutane suppresses acne by shutting down oil production in sebaceous glands, making the skin dry, extremely fragile and impairing its ability to regenerate new epidermal cells.

Tim Alster MD & Lydia Preston

The Essential Guide to Cosmetic Laser Surgery, Alliance Publishing, 1997

NEW a cautionary tale of the dangers of roaccutane

A letter about the damaging effects of Roaccutane

Dear Helen,

How lovely to receive your letter of 10th January. I know it's now a little late to do so, but I reciprocate your new millennium greetings!

I did write to my consultant dermatologist but foolishly forgot to send you a copy of the letter. However, it was more anti-Roaccutane than anything else so please take this letter to be my pro-Helen Sher missive! What I write below, please feel free to use and reproduce in any way you wish.

As you know, after a period of immense stress I developed a facial rash - the first I had had in my life. I had been under three doctors who had in turn prescribed over nine different creams and a course of antibiotics, all to no avail. I had been told the rash was seborrhoeac dermatitis, then acne. Finally I had been on a four month course of Roaccutane.

During the time spent taking Roaccutane I suffered immensely. My skin burnt and flaked off, I was continually red and my lips cracked and bled. Each night I would have to smother myself with Vaseline to get any relief at all. In short, I felt - and looked - like a freak.

At the end of the course my spots started to return. I was suffering from dreadful depression which has been made much worse by the Roaccutane.

I could hardly believe that my spots were back after such a gruelling course of strong medication. I had been assured that the Roaccutane "would work". There was never any mention that it might not and it was sold to me as a wonder drug that would change my life.

The only thing that has changed my life was visiting The Sher System. As you'll remember, I came to you in a very low state. You removed all my make-up which is something that not one of my doctors bothered to do. You immediately diagnosed Rosacea, which is very interesting, as I have since discovered that both my mother and maternal grandmother suffered from this condition. At no time did any of the consultants suggest I might be suffering from Rosacea but you saw at once!

I began using your products meticulously at the end of October. I have to say that after all the reassurances I had received from the medical profession about various creams and drugs I held out little hope that the Sher regime would help me. However, after a week I realised that my spots had stopped spreading. Within two weeks my skin was as much as 50% better - I could hardly believe it! After a full month using your products I can honestly say that I am not only cured but that my skin is better than it has been in my life.

I still religiously splash! No matter how tired I am or how late the hour, I use the facial wash and splash at least 20 times. I actually enjoy using all the Sher products, which is an added bonus.

Helen, thank you for giving me back my confidence. I now have the sort of skin I used to dream of having and if I can ever be of any help to you in the future you only have to ask.

With thanks again,

Jenefer N