Will New Acne Drug Dosing Options Make Curing Acne Faster & Easier?

November 17, 2006

Imagine, you are a teenager with acne. Frustrated with your skin, you visit a dermatologist. Next, the dermatologist prescribes a series of acne medications like benzoyl peroxide, antibiotics or oral retinoids. And then, if all of that fails to improve the acne, after about two years of testing your acne medication options, your doctor may finally prescribe what is currently considered the ultimate acne drug- isotretinoin.

But is there anyway to cut down that two year quest for acne control? A new study presented by the Journal of the European Academy of Dermatology & Venereology suggests yes.

In this study, researchers gave sixty patients with mild to moderate facial acne 0.5-0.75mg of isotretinoin per kilogram of body weight each day for one week, every four weeks.

At the study’s conclusion six months later, forty-one (68.3%) of the 60 patients completed the therapy. Complete improvement was observed in 34 patients (82.9%). All reported adverse effects were mild and did not require stopping the treatment.

Based on this premliminary study, reseachers suggest that intermittent isotretinoin treatment can be a safe and effective choice for patients with mild or moderate acne.

But don’t rush off nudging your dermatologist for isotretinoin just yet. Since the FDA started the iPLEDGE program, which was designed in response to control birth defects linked to isotretinoin usage, everyone taking this drug must register with the program- including males.

As of March 1, 2006, the FDA has placed more protective barriers to isotretinoin access. For example only physicians registered and activated in the iPLEDGE system can prescribe isotretinoin and only patients registered and qualified in the iPLEDGE program can receive isotretinoin.

Isotretinoin gained such heavy regulation because this potent drug mitigates most of the conditions that lead to severe acne like, removing comedones (clogged pores), reducing oil secretion and increasing the skin cell turnover rate.

It’s effectiveness has also made isotretinoin the subject of numerous studies regarding its potential side effects. For example, this past September group of researchers lead by Deepa Reddy examined all of the adverse reports filed with the FDA between 1997 and 2002. The investigators found that eighty-five cases of inflammatory bowel disease (IBD) were linked to isotretinoin usage. According to Reddy, in all 85 cases isotretinoin was at least a “possible” cause of the IBD.

In other cases, isotretinoin usage has even been anecdotally linked to suicide and depression. Regardless of these possible threats, Nicole Dial, President of Noixia, a San Diego based formulator of acne scar removal products says that, “People with acne understandably want clear skin and they want it fast, so it’s not surprise that patients usually ask their doctors for isotretinoin first.” Dial predicts that it is not probable doctors will prescribe intermittent usage of isotretinoin for mild acne just yet.

For now, while intermittent isotretinoin usage requires further study before it is a widespread practice, Dial suggests your dermatologists may be more inclined to offer topical retinoids for mild acne. Otherwise she suggests, “You could look for topical creams that contain retinaldehyde, retinol, and retinyl esters because these agents help renew the skin and limit radical damage, both of which will help improve acne prone skin.”

Sources:
Kaymak, Y and N. Ýlter. The effectiveness of intermittent isotretinoin treatment in mild or moderate acne. Journal of the European Academy of Dermatology & Venereology, Volume 20, Number 10, pp. 1256-1260(5), November 2006.

Reddy, Deepa, Corey A Siegel,; Bruce E Sands and Sunanda Kane. Possible Association Between Isotretinoin and Inflammatory Bowel Disease. The American Journal of Gastroenterology, Volume 101, Number 7, pp. 1569-1573(5), July 2006.

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