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Are there oral medications to treat acne?

By: Rachel Day, M.D.


What is Isotretinoin (or Accutane)?

Isotretinoin is an oral medication used to treat moderate to severe cases of acne.  In most cases cystic or stubborn inflammatory and closed pore acne that has not cleared with other acne treatments including topical retinoids, topical antibiotics, or oral antibiotics.

This medication, which comes in pill form, works by targeting the oil gland itself. It shrinks the oil glands (aka sebaceous glands) slowing the production of oil, reducing inflammation and preventing the pores from getting clogged. Isotretinoin is the most effective way to treat and produce long term results for acne free skin.

If isotretinoin is the most effective way to treat acne why doesn’t everyone take it?

While isotretinoin is an extremely effective medication there are many misconceptions about the drug that prevent patient who would get the greatest benefit from isotretinoin from seeking more information. Dr. Day at OneSkin Dermatology in Chambersburg is a trusted dermatologist who has safely treated hundreds of patients with isotretinoin to clear their acne.

Dr. Day addresses the most common misconceptions about isotretinoin (Accutane) treatment and how she safely guides patients and families through this life-changing treatment course that can prevent acne scarring and permanent disfigurement. 

“At OneSkin Dermatology it is our mission to empower patients and families to have accurate information about all treatment options to make the best decisions for themselves or their loved ones.  It is extremely heartbreaking to see a patient have acne scars because past providers did not want to take the extra time to listen to and address their concerns.” Dr Day.

Who is a candidate for isotretinoin therapy?

Patients with severe nodulocystic acne or even mild or moderate acne that hasn’t responded to previous treatments are excellent candidates for isotretinoin. The bottom line is that in any patient with acne scarring isotretinoin should at least be considered. “We are so much better at treating active inflammatory acne then treating acne scarring on the back end.” Dr. Day

In the past, isotretinoin used to be thought of as the last resort medication, but at OneSkin Dermatology we utilize this effective medication earlier on in the disease course because it is safe with the appropriate physician monitoring. There are several safety concerns for the overuse of antibiotics in acne patients including gut health disruption, bacterial resistance and yeast infections to name a few. Dr. Day reviews your entire treatment history including how long you’ve had antibiotic exposure to discuss what are the safest treatment options for you going forward.  

How does isotretinoin work to stop acne?

The major factors that cause acne include:

  • Overproduction of oil
  • Inflammation from bacteria feeding on the oil
  • Abnormal shedding of skin cells, clogging the pores
  • Hormones (stress and sex hormones)

Isotretinoin targets the first three causes by shutting down the sebaceous glands and the bacteria which depend on the oil to cause inflammation. 

The medication also helps normalize proper skin shedding, which cuts down on blackhead and whitehead formation.

So why does isotretinoin get such a bad reputation?

Isotretinoin is a highly government-regulated medication. All dermatologists, pharmacists, and patients that are involved with isotretinoin must be enrolled in the iPLEDGE program. Many offices do not spend the time to explain the ins and outs of going through an Accutane course leaving patients to seek misguided information on the internet. Dr. Day is very experienced at walking patients and parents through the consent process, discussing all risks and benefits to taking the medication. In her hands OneSkin Dermatology has a >95% course completion rate for patients taking isotretinoin.

If you have acne that is not improving, causing distress, and leading to scarring, we can help! Schedule your acne consultation today to learn more about isotretinoin and our other acne treatments available at OneSkin Dermatology in Chambersburg, Franklin County’s number one dermatology office.

* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.