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Roaccutane (Accutane in the USA) is an oral medicine used to treat severe acne. It contains the active ingredient isotretinoin, which is related to vitamin A. It is included in a group of medicines called retinoids. Roaccutane, in the UK, can only be prescribed by specialist doctors like a dermatologist.


How does Roaccutane work? 

Severe acne is acne that is causing a lot of scarring and is characterised by a lot of large, painful cysts and nodules which extend deep into the skin and cover a large area. It is often stubborn and hard to clear with over-the-counter acne treatments. 

In people with acne, there is an overproduction of sebum which is an oily substance that lubricates the hair and skin. This overproduction can mix with dead skin cells and plug the hair follicles which can then become infected by bacteria and lead to painful spots.

Roaccutane works to prevent this by reducing the production of sebum and killing the bacteria on the skin. It can also help to reduce any swelling and redness of the skin as it has anti-inflammatory properties.

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How long does Roaccutane take to work?  

During the first couple of weeks of the treatment, you might find that your acne gets worse before it gets better. This is just a sign that the Roaccutane is working. Most patients find that they start seeing some noticeable differences around the 8–12-week mark.

The British Association of Dermatologists says that about 9 out of 10 patients see a significant improvement in their acne with a single course of Roaccutane (isotretinoin).


How to take Roaccutane 

Roaccutane comes in capsule form and is usually taken once or twice a day for a period of up to16-24 weeks. It is available as Roaccutane 20mg or 10mg strengths. 

The dose is calculated based on the patient’s body weight and the individual needs of the patient. Isotretinoin capsules should not be taken on an empty stomach as they will not work as effectively. It works best if taken after a meal.

If you take too many capsules by accident, your GP or pharmacist should be informed immediately. If you miss a dose, take it as soon as you remember unless it is almost time for your next dose then skip the missed dose and never take a double dose.


Who can use Roaccutane? 

Roaccutane is prescribed by dermatologists for adults and teenagers with severe acne. It is not licensed for use by anyone under the age of 12 years. Roaccutane is only used when acne has not cleared up with the use of other treatments, such as lymecycline or Duac Gel.

Roaccutane is unsafe to use by those who are pregnant and breastfeeding. This is due to its risk of causing birth defects and harming the child. Whilst being treated with Roaccutane the NHS recommend that women use two methods of contraception and take a pregnancy test before, after and for each month of the treatment. Your dermatologist will also enter you into the Pregnancy Prevention Programme.

The patient should also be aware that Roaccutane can have severe side effects associated with its use before starting treatment. You will need to have routine blood tests whilst taking Roaccutane.

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Roaccutane side effects

Some of the most common side effects include skin sensitivity to sunlight, dry skin, dry lips and eyes, headaches, rashes and aches and pains in muscles or joints. These can affect more than 1 in every 10 people taking Roaccutane. If you experience dry skin, nose or lips you can apply lip balm and moisturiser regularly to help.

There is also a risk of serious side effects of Roaccutane. These include frequent infections and unexplained bruising, both of which can be signs of blood disorders. Other side effects include blood in the stool and severe stomach pains. There is also a risk of mental health issues like changes in mood or suicidal thoughts. If you experience any of these side effects stop taking Roaccutane and call 111. 

In rare cases, it’s possible to have a serious allergic reaction to Roaccutane. This may cause you to have side effects such as trouble breathing, tightness in the chest/throat, or swelling in the mouth, face or tongue. If this happens, you need immediate treatment in hospital and should call 999 or go to A&E as soon as possible.

Roaccutane should not affect a person’s ability to operate machinery or drive. Excessive sun exposure should be avoided when being treated, because your skin may be more prone to sunburn. Always take extra precautions such as applying sunscreen consistently.