Acne Causes And Treatments
Each hair follicle is connected to sebaceous glands, which secrete an oily substance known as sebum to lubricate the hair and skin. Sebum normally travels up along the hair shaft and then out through the opening of the hair follicle onto the surface of your skin. When your body produces an excess amount of sebum and dead skin cells, the two can accumulate in the hair follicle and solidify as a soft plug. As the plug grows, the follicle wall can rupture, allowing more oil and skin cells to accumulate. This is the underlying cause of acne. Bacteria can trigger additional inflammation and infection resulting in complications of acne. Acne is not purely a teenage predicament, 20 to 40% of the adults do encounter problems with acne. It is estimated that more than 40% of teens and young adults have acne that is severe enough to require treatment by a physician, according to the American Academy of Dermatology.
Common Acne Treatment
Acne treatments usually work by reducing oil production, speeding up the growth of new skin cells and the removal of dead skin cells, or fighting bacterial infection. Some acne treatments, especially combination therapies, work by doing two or three of these.
While there are many types of over the counter medications and remedies for acne many times a prescription medication may be needed for more severe types of acne such as cystic acne or nodule acne. The first line of defense when using prescription medications usually include topical retinoid and antibiotics. Using these drugs in combination often produces the best results, but they must be taken for as long as the acne persists, which, for some people, can be many years. Although generally well-tolerated, they frequently cause skin dryness and irritation. Persistence and patience are required. "Teens want to see the dermatologist today and be better tomorrow," says Dr. Karl Beutner, associate clinical professor of dermatology at UC San Francisco and co-author of the American Academy of Dermatology's current acne treatment guidelines. "For medications to be efficacious, they need to be used religiously. It often takes good compliance over a long period of time to see the difference." Oral antibiotics including doxycycline and minocycline are also mainstays of treatment, particularly when topical fail.
Treating Acne With Isotretinoin
Isotretinoin, best known by the brand name Accutane, has typically been a drug of last resort, used by those with severe acne. Isotretinoin is a medication used for the treatment of moderate to severe acne. It was first developed to be used as a chemotherapy medication for the treatment of brain cancer, pancreatic cancer and more. It is still used in the treatment of these cancers to this day because of its ability to kill rapidly dividing cells. The effects of the medication are systemic and non-selective which may contribute to the tendency for users to experience severe Isotretinoin side effects. In some cases, it is used to treat Harlequin type ichthyosis, a usually lethal skin deformation in which sufferers develop armor plated-like skin and usually die soon after birth. Isotretinoin is a retinoid, meaning it is derived from vitamin A and is found in small quantities naturally in the body. Oral isotretinoin is marketed under various trade names, most commonly Roaccutane (Hoffman-La Roche; simply Accutane before July 2009), Amnesteem (Mylan), Claravis (Barr), Clarus (PremPharm), Decutan (Actavis), Isotane (Pacific Pharmaceuticals), Izotek (BlauFarma), Oratane (Genepharm Australasia), or Sotret (Ranbaxy), while topical isotretinoin is most commonly marketed under the trade names Isotrex or Isotrexin (Stiefel).
Accutane Prescribing Restrictions
Since March 1, 2006, the dispensing of isotretinoin in the United States has been controlled by a FDA-mandated website called iPLEDGE – dermatologists are required to register their patients before prescribing Accutane and pharmacists are required to check the website before dispensing the Accutane, Isotretinoin or Roaccutane. The Accutane prescription may not be dispensed until both parties have complied. A physician may not prescribe more than a 30-day supply of Isotretinoin, Accutane or Roaccutane at one time. A new prescription may not be written for at least 30 days. Pharmacies are also under similar restriction. There is also a 7 day window from the time the prescription is written in which the medication must be picked up at the pharmacy. If the original prescription or Accutane, Amnesteem, Claravis Isotretinoin, Roaccutane or Sotret is lost, or the pick-up window is missed, the patient must re-qualify to have another prescription written. Doctors and pharmacists must also verify written prescriptions in an online system before patients may fill the prescription.
Accutane Side Effects & Lawsuits
Adverse drug reactions associated with Accutane, Amnesteem, Claravis, Isotretinoin, Roaccutane and Sotret therapy include: Inflammatory Bowel Disease (IBD), Ulcerative Colitis and Crohn’s Disease. Several scientific studies have posted that isotretinoin is a possible cause of Crohn’s Disease and Ulcerative Colitis in some individuals. Three Accutane cases in the United States have gone to trial thus far, with all three resulting in multi-million dollar judgments against the makers of Accutane; there are more than 425 cases pending. An excerpt from one of the studies of the association between Isotretnoin and Inflammatory Bowel Disease states the following: OBJECTIVES: The Physician's Desk Reference lists inflammatory bowel disease (IBD) as a possible adverse event associated with the use of isotretinoin, a popular acne prescription medication. Our aim was to perform a systematic examination of reports of IBD associated with isotretinoin use. METHODS: All reports filed with the Food and Drug Administration (FDA) via the MedWatch system were requested and reviewed. Strength of causality was determined using the Naranjo adverse drug reaction (ADR) probability scale. RESULTS: All of the adverse reports filed with the FDA between 1997 and 2002 were accessed and reviewed. Eighty-five cases of IBD associated with isotretinoin use were reported. According to the Naranjo ADR probability scale, 4 cases (5%) scored in the "highly probable" range for isotretinoin as the cause of IBD, 58 cases (68%) were "probable," 23 cases (27%) were "possible," and no cases were "doubtful." CONCLUSIONS: In a subgroup of patients, isotretinoin might serve as a trigger for IBD.
What Is Inflammatory Bowel Disease?
Inflammatory bowel disease (IBD) is the name of a group of disorders in which the intestines (small and large intestines or bowels) become inflamed (red and swollen). This inflammation causes symptoms such as:
Severe or chronic (almost all of the time) pain in the abdomen (belly)
Diarrhea — may be bloody
Unexplained weight loss
Loss of appetite
Bleeding from the rectum
Joint pain
Skin problems
Fever
Symptoms can range from mild to severe. Also, symptoms can come and go, sometimes going away for months or even years at a time. When people with IBD start to have symptoms again, they are said to be having a relapse or flare-up. When they are not having symptoms, the disease is said to have gone into remission.
The most common forms of IBD are ulcerative colitis (UHL-sur-uh-tiv koh-LEYE-tiss) and Crohn’s (krohnz) disease. The diseases are very similar. In fact, doctors sometimes have a hard time figuring out which type of IBD a person has. The main difference between the two diseases is the parts of the digestive tract they affect.
Ulcerative colitis affects the top layer of the large intestine, next to where the stool is. The disease causes swelling and tiny open sores, or ulcers, to form on the surface of the lining. The ulcers can bleed and produce pus. In severe cases of ulcerative colitis, ulcers may weaken the intestinal wall so much that a hole develops. Then the contents of the large intestine, including bacteria, spill into the abdominal (belly) cavity or leak into the blood. This causes a serious infection and requires emergency surgery.
Crohn's disease can affect all layers of the intestinal wall. Areas of the intestines most often affected are the last part of the small intestine, called the ileum, and the first part of the large intestine. But Crohn's disease can affect any part of the digestive tract, from the mouth to the anus. Inflammation in Crohn's disease often occurs in patches, with normal areas on either side of a diseased area.
In Crohn's disease, swelling and scar tissue can thicken the intestinal wall. This narrows the passageway for food that is being digested. The area of the intestine that has narrowed is called a stricture (STRIK-choor). Also, deep ulcers may turn into tunnels, called fistulas (FISS-choo-luhss), that connect different parts of the intestine. They may also connect to nearby organs, such as the bladder or vagina, or connect to the skin. And as with ulcerative colitis, ulcers may cause a hole to develop in the wall of the intestine.
IBD is not the same as irritable bowel syndrome (IBS), although the symptoms can be similar. Unlike inflammatory bowel disease, IBS does not cause inflammation or damage in the intestines.
In many people with IBD, medicines can control symptoms. But for people with severe IBD, surgery is sometimes needed.
Accutane Lawsuit
If you or a loved one have taken Accutane, Amnesteem, Claravis, Isotretinoin, Roaccutane or Sotret and have experienced severe Accutane side effects such as Inflammatory Bowel Disease (IBD), Ulcerative Colitis or Crohn’s Disease you may be entitled to compensation. Contact the Accutane lawyers of Ennis & Ennis, P.A. today to inquire about the Accutane Lawsuit and get a free, confidential, legal case evaluation by filling out our online case evaluation form or calling us toll-free at: 1-800-856-6405.
Information on this website is not intended to provide medical advice. Under no circumstances should you discontinue taking any medication, including Isotretinoin, Accutane or one the generic versions of Isotretinoin, without first consulting with your doctor.
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