Although Roaccutane treatment gives very effective results, it can cause very serious negative effects on the skin and body. You should get to know Roaccutane a little more closely in order to take care of your skin during and after Roaccutane treatment and to do your skin care properly for a better skin. In this study, we tried to explain the effects and side effects of Roaccutane and the steps you can pay attention to in skin care.
The use of retinoids in the treatment of dermatological diseases is one of the most exciting developments in recent years.
When Roaccutane (Isotretinoin) is used, the oil production of the skin is reduced by 90% or more. When the skin oil decreases, the environment where bacteria can feed and multiply naturally decreases and acne formation is prevented in this way. This can provide long-term and permanent improvements in the treatment of various lumps and cysts. But it also has many side effects. For example, it is known to cause visual impairment in the dark, pressure on the skull, and liver problems. It can cause dryness, itching, rash on the face. It can cause dryness around the mouth, lips, nose, around the eyes and in the eyes. Nosebleeds are also common among those who use the drug. We have tried to examine them in detail below. In addition, we tried to convey what should be considered during and after Roaccutane treatment in order to minimize the side effects.
How Should Skin Care Be Taken During and After Roaccutane (Isotretinoin) Treatment?
During Roaccutene treatment, many changes occur in the skin as the oil production of the skin decreases by 90% or more. It can turn into dry, easily inflamed allergic skin. Exfoliation can also be observed. Cleaners with gentle ingredients should be preferred for skin cleaning and the skin should not be irritated with harsh (SLES, SLS, Sulfates) ingredients. In addition, ingredients such as essences and ethyl alcohol that trigger skin dryness and cause allergic reactions should be avoided.
As a cleansing gel: You can choose AHA/BHA Exfoliating Gentle Cleansing Gel. It is a creamy and very gentle cleanser, it does not irritate the skin.
After cleansing the skin, a well-formulated tonic with a moisturizing effect should be applied, and then the skin should be moistened with serum and moisturizer. Broad spectrum sunscreen should not be neglected during the day and should be renewed every 2 hours. Moisture masks should not be neglected in weekly maintenance.
We recommend that you use a pure Cyrene Hyaluronic Acid Intensifier containing hyaluron, prebiotics and ceramides as a serum to avoid concerns such as sensitization and dryness on your skin. You can minimize the damage caused by Roaccutane to your skin with this serum. You can use it before moisturizer day and night. It is a very good serum containing pure Hyaluronic acid.
Developed with probiotic technology as a moisturizer Cyrene Skin Rescue Moisturiser is suitable for you. Prebiotics help the skin to continue its healthy functions by regulating the skin microbiome. In addition, by supporting the good bacteria in the skin microflora, they help to destroy the bad (pathogenic) bacteria that cause sensitivity etc.
We recommend you to use Cyrene Invisible Physical Sunscreen, which is designed especially for sensitive skin, contains 100% mineral filter, does not contain chemical filters and harmful ingredients for the skin, and does not react with the skin.
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Although Roaccutane (Isotretinoin) side effects have been minimized, undesirable side effects such as mucocutaneous side effects, elevation in serum lipid levels and teratogenicity (factors or substances that cause congenital deformities in the offspring as a result of passing from the mother to the baby's circulation through the placenta) still exist. continues .
As can be seen from the studies conducted by Peck et al., the superiority of Roaccutane (Isotretinoin) has been confirmed in the treatment of severe nodulocystic acne that relapses after conventional treatments .
Systemic Roaccutane (Isotretinoin) is the only drug that is effective on all factors involved in the pathogenesis of Acne Vulgaris. It both provides effective improvement in acne lesions and prolongs the time for the disease symptoms to fade.
- Reduces the size of sebaceous glands (Sebum production glands) and sebum production. During treatment, sebum production is reduced by 90% or more.
- Normalizes follicular keratinization, prevents the formation of new comedones.
- Indirectly inhibits the growth of P. acnes by changing the follicular environment.
- It shows anti-inflammatory effect.
After discontinuation of Roaccutane (Isotretinoin) treatment, sebum production and P. acnes levels that decreased during the treatment may increase again. It is a potent inhibitor of enzyme reactions required in retinoic acid and hydroxysteroid metabolism, particularly androgen and estrogen metabolism [3,4].
Roaccutane was originally only approved for the treatment of severe, persistent nodular acne. However, when the use of between 1993 and 2000 was examined, it decreased from 63% to 46% in severe acne, while the rate increased from 31% to 49% in mild and moderate acne .
Oral Roaccutane (Isotretinoin) therapy is very effective in severe nodulocystic acne and in most cases responds to 4-6 months of treatment [2,6,7,8].
Oral Roaccutane (Isotretinoin) is the first choice in the treatment of severe acne. Usually, the response may not be evident even 1-2 months after starting treatment. Similarly, its effect may still persist a few months after treatment is discontinued .
Roaccutane (Isotretinoin) Side Effects
Before using Roaccutane (Isotretinoin), possible side effects should be carefully studied and understood. To summarize:
Teratogenicity: Causing congenital deformities in the offspring as a result of the possibility of miscarriage in pregnant women or the transfer from the mother to the circulation of the offspring through the placenta.
Ocular: Decreased night vision, Dry eyes, Stapyhylococcus aureus infections
Bone: Osteophyte (local protrusion-like bone growth or ridge in bones) formations, Osteoporotic changes in long bones, Premature closure of epiphyses.
Lipid metabolism: Hypercholesterolemia (Excess cholesterol in the blood), Hypertriglyceridemia (Increased triglyceride level in the blood).
Hepatic: Elevated transaminases, Rarely toxic hepatitis.
Neurological: Depression - suicidal ideation
Muscle: Myopathy (Muscle disease).
Gastrointestinal: Exacerbation in inflammatory bowel diseases, Pancreatitis (due to triglycerides).
One of the biggest and most serious problems that Roaccutane (Isotretinoin) can cause is Teratogenicity. Unfortunately, we cannot find studies and researches about this in Turkey, but there are very detailed archives in the USA.
According to US sources, 3.6 million women become pregnant every year and 45% of these pregnancies are unintended. Pregnancy occurs in 3 out of every 1000 patients using Roaccutane (Isotretinoin) in the USA. 91% of these patients reported that they were warned that the drug may cause congenital damage if used during pregnancy (Roche Accutane Drug Safety Database 1991-1998).
Female patients should be absolutely sure that they are not pregnant before Roaccutane (Isotretinoin) treatment, and they should not become pregnant during the treatment and until 1 month after the end of the treatment. After this period, every expectant mother can conceive and give birth to healthy babies. At this stage, there is no difference between a mother who has used isotretinoin and a mother who has not used it.
FDA has over two thousand cases of pregnancy while using Roaccutane (Isotretinoin) since 1982. Most of these pregnancies ended in miscarriage. Although some of the babies born were healthy, more than 160 babies were born with birth defects according to FDA data .
The second most serious problem that Roaccutane (Isotretinoin) can cause is depression. After effective treatment of acne with Roaccutane (Isotretinoin), the psychosocial problems associated with acne also improve in many cases. However, in some patients with depression, there is no improvement in depression with treatment. This may be due to many factors such as ineffective fighting strategies, acne scars (blemishes), Roaccutane treatment .
Hazan et al., in their study published in 1983, reported that 5.5% of patients using Roaccutane (Isotretinoin) had symptoms of depression .
In a study published in 1999, the relationship of 6 drugs (isotretinoin, minocycline, tetracycline, doxycycline, diane and oxytetracycline) used in the treatment of acne vulgaris with suicide, suicide attempt and suicidal ideation was investigated. In this study, a total of 1830 psychiatric side effects reported worldwide until 1999 were reached, and it was determined that 59.8% of them were due to Roaccutane (Isotretinoin). It has been reported that 47 suicides and 56 suicidal thoughts were associated with Roaccutane (Isotretinoin) use [18, 19, 20].
Roaccutane (Isotretinoin) must affect brain functions in order to cause depression. This topic was published in 2005 by Bremner et al. In patients treated with Roaccutane (Isotretinoin) and antibiotics, brain functions were measured with fluorodeoxyglucose positron emission tomography before and 4 months after the treatment. ].
Other side effects of Roaccutane (Isotretinoin) may include drying of the skin and mucous membranes, nosebleeds, hoarseness, eye inflammation, reversible corneal opacity, and contact lens intolerance [22,23].
Dermatological side effects are exanthema (skin flushing and symptomatic skin eruptions), itching, facial redness/dermatitis, sweating, pyogenic granuloma (tubules with pus), nail degeneration, increased lump formation, thinning of hair strands and reversible hair loss, can be counted as hair growth and hyperpigmentation
Muscle pain, joint pain, hyperostosis (overgrowth or development of bone tissue) and tendonitis may develop in the skeletal-musculoskeletal system. Sensory disorders may include visual disturbances, photophobia, dark adaptation disorders (decreased night vision), cataracts, corneal inflammation, and hearing impairment at certain frequencies in isolated cases [24, 25, 26].
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