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SUNDAY AUGUST 1

HEALTH DEBATE

IS ROACCUTANE A GOOD OPTION FOR ACNE?

THE DOCTOR DR CINDY PAN

R

oaccutane is the trade name for a medication called isotretinoin, which is a treatment for severe cystic acne. Roaccutane tends to be considered when other treatments have failed, but it is really for cystic, scarring acne that it is most useful and appropriate. The best thing to do is to talk to your GP, who can assess your acne, discuss what measures you have tried and what your other options might be. Roaccutane can only be prescribed by a specialist dermatologist, so if necessary, your GP can refer you accordingly. Roaccutane works by cutting down the amount of sebum (oil) made by your skin’s glands; it also reduces bacteria and inflammation and opens clogged pores. You need to take it for four to eight months and

while it is generally highly effective it takes time to work and can sometimes initially make acne worse before it gets better. The drug has a lot of potential side effects including dry eyes, dry lips, skin sensitivity and increased tendency to sunburn. Your skin and hair may be more fragile during treatment, so avoid waxing, sun exposure, solariums, dermabrasion and electrolysis. Less commonly, there may be visual disturbances, mood changes and other side effects that your dermatologist will discuss with you. You cannot take Roaccutane while pregnant or breastfeeding, so it is vitally important to use contraception for a month before, during and one month after taking it. Roaccutane is not a treatment to be taken lightly so follow your dermatologist’s instructions carefully, return for regular visits and consult your doctor if you have any unwanted effects.

■ Dr Cindy Pan has had over 10 years of clinical practice experience. Her books include Pandora’s Box: Lifting The Lid On Life’s Little Nasties (HarperCollins) and Playing Hard To Get (HarperCollins). She appears on television, lectures and speaks about all aspects of health, relationships and wellbeing.

I

have never had severe acne so I can only imagine the emotional trauma individuals would experience. As such, Roaccutane may seem as though it is the best or only solution. If you’re in this situation and are taking it or about to take it, I can understand. In the 1930s acne was treated with toxic doses of vitamin A. This prescription cleared acne but caused a lot of negative side effects. In 1982 this principle was advanced with the development of a retinoic acid derivative, isotretinoin, or Roaccutane. Interestingly, when you take a prescription of therapeutic vitamin A, you can also get a positive outcome, but without the side effects. Roaccutane is associated with marked liver effects, hormone changes and psychological effects. I have seen a number of patients over the years who have had shocking side effects and often no improvement to their acne.

THE NATUROPATH LEAH HECHTMAN Vitamin A is a complicated nutrient and you have to monitor the dose carefully. Fat-soluble vitamins are stored in the body for extended periods of time and when toxic levels are reached, all processes that require fat substances are negatively affected. One of the first things a psychiatric hospital asks on admission is the current or past use of Roaccutane. This is due to the role of lipids (fats) in the body that are involved in mood regulation and not simply for sebum (oil) production on the skin. Additionally, some studies have correlated the incidence of Crohn’s disease and ulcerative colitis with Roaccutane usage. If it seems as though it is the only solution, then review the literature, do some research, speak to other health professionals and gain a thorough understanding of the drug.

■ Leah Hechtman is a naturopath and fertility specialist. She is a lecturer, author, researcher and industry consultant and has her own clinical practice in Sydney, NSW. She specialises in fertility, reproductive and psychological health. For more information visit www.naturalhealthfertility.com

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