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Side Effects of Accutane That Men are Likely to Experience

Accutane is a retinoid drug that can cause several side effects while treating severe nodular acne. Some of the side effects of this medication are quite serious, but not all users experience them. This HealthHearty article will give you a brief idea about the adverse effects that men can experience while using this drug.
Chandramita Bora
Last Updated: Apr 13, 2018
Accutane or isotretinoin is a very strong medication that is used for the treatment of severe nodular or cystic acne. This medication was actually developed to be used for cancer treatment. But today, it is mostly used for the treatment of severe nodular acne. The generic name of accutane is isotretinoin, and it is derived from vitamin A.

So, accutane is basically a retinoid, and is manufactured as a drug by the Roche Pharmaceuticals. It was approved by the FDA in 1982 for the treatment of severe acne in people older than 12 years of age. Though isotretinoin can be quite effective in treating nodular and cystic acne, it is linked to a series of side effects, of which some are quite serious.

This drug has been found to be associated with several birth defects. So, it is considered to be a teratogen. This drug can also affect sexual health of men, besides causing a change in their mood and behavior. Here is a brief overview of how accutane works, and the side effects that men can experience while using this drug.
How Accutane Treats Acne

Accutane has been found to be very effective in reducing the secretion of sebum by the sebaceous glands. Acne is mainly caused by the clogging of the skin pores due to the excessive secretion of oil or 'sebum' by the sebaceous glands. The blocked skin pores harbor bacteria and other microorganisms, which can cause infections and inflammation. Accutane can help prevent the skin pores from getting clogged and destroy the acne-causing bacteria, besides helping the skin to renew itself.

Possible Side Effects in Men

Accutane is a strong medication, and so, it is used only when the conventional treatment options fail to treat severe acne. It is usually not used for mild and moderate acne. Though this medication can be quite effective in treating acne, some of its side effects have generated worldwide concerns. Below here are some side effects that men can experience while on the drug. However, it is important to note that all the side effects mentioned in this article may not be experienced by all individuals.
Dry Skin and Mucous Membrane

Excessive dryness of the skin, lips, and the mucous membrane, as well as fragile skin and skin peeling are some of the common side effects associated with this drug. These side effects are caused by the decreased production of sebum by the sebaceous glands. Accutane can shrink the sebaceous glands, and so, both men and women using this drug can experience skin dryness to some extent.

Liver Damage

Some, not all accutane users, have reported this side effect, which can be irreversible at times. Liver damage caused by isotretinoin can lead to cirrhosis, and in extreme cases, the patient may require a liver transplant. Studies conducted in this regard have demonstrated a connection between accutane use and liver damage. In 2006, a research conducted in the University of California observed that about 11% isotretinoin users tested in the study had elevated liver enzymes.

In clinical trials, mild to moderate increases in liver enzymes have been observed in about 15% individuals using accutane. Therefore, liver enzyme tests are performed before prescribing the medication, and also after four weeks following the treatment. Alcohol needs to be avoided during the course of treatment. People having liver diseases should avoid the drug or inform their physicians/dermatologists before taking isotretinoin. The signs and symptoms that liver damage can produce are:

✧ Pain in the right upper quadrant of the abdomen
✧ Abdominal pain that radiates to the back
✧ Jaundice
✧ Accumulation of fluid in the abdomen
Gastrointestinal Disorders

Inflammatory bowel disease (IBD), ulcerative colitis, and Crohn's disease are the gastrointestinal side effects that can be caused by isotretinoin. Though many cases of IBD associated with isotretinoin were reported between the period of 1997 to 2002, the relation between the two was not validated. In 1999, a letter published in the The American Journal of Gastroenterology cited that a connection can exist between isotretinoin and IBD. In 2005, another study published in the same journal mentioned that accutane use can trigger IBD in some people. Even FDA has received more than two hundred cases of IBD associated with the use of accutane, between the period of 2003 to 2011.

Pseudotumor Cerebri

Sometimes, accutane may cause pseudotumor cerebri or benign intracranial hypertension, which however, is not a very common side effect of this medication. It is a neurological disorder characterized by the elevated intracranial pressure. The intracranial pressure usually rises due to brain tumor or some other diseases. But in pseudotumor cerebri, this happens in the absence of any tumor or disease. The signs and symptoms of this condition are:

✧ Headaches
✧ Nausea
✧ Vomiting
✧ Tinnitus or ringing in the ear
✧ Double vision
✧ Blurred vision

Pancreatitis

Accutane can occasionally cause acute pancreatitis with or without elevated triglyceride levels. If the levels of triglycerides in blood cannot be controlled, then accutane needs to be discontinued. The main symptoms of pancreatitis are:

✧ Pain in the upper abdomen
✧ Nausea and vomiting
✧ Fever
✧ Jaundice

Depression and Suicidal Tendency

Accutane is often blamed for its effects on human mood and behavior. Some of the serious side effects of isotretinoin in men are aggressive behavior, depression, psychosis, and suicidal thoughts. Many isotretinoin users have reported these side effects over the years. In 2003, the FDA has received many reports of suicides and depression associated with the use of this medication.

Though some people are of the opinion that severe nodular acne can also be a reason behind depression, many cases of depression (in accutane users) come from those who do not have a history of depression and other psychiatric disorders. So, please inform your physician as soon as possible, if you experience the following side effects while using this drug:

✧ Irritability
✧ Anxiety
✧ Problem in concentrating
✧ Seeing or hearing things that are not real (hallucinations)
✧ Feeling sad for no apparent reason
✧ Thoughts of hurting or killing oneself
✧ Loss of interest in activities you used to enjoy

Erectile Dysfunction

Many men have reported to experience side effects like erectile dysfunction, impotence, partial or complete loss of libido, and anorgasmia while and after using isotretinoin. A very small amount of the drug can be present in the semen, but it is not known with certainty whether this small amount can affect the fetus if your partner is or may become pregnant. If your partner is pregnant or may become pregnant, then it is better to maintain caution and inform your physician about it before taking accutane.

Other Possible Side Effects

Apart from the aforementioned side effects, accutane can produce several other adverse effects, which are enlisted below:

✧ Dry mouth and nose
✧ Nosebleeds
✧ Increased sensitivity to sunlight
✧ Dry eyes
✧ Eye irritation
✧ Conjunctivitis
✧ Hair loss or thinning
✧ Impetigo
✧ Muscle and joint pain
✧ Cataracts
✧ Corneal scar
✧ Hepatitis
✧ Blood in urine
✧ Decreased pigmentation of the skin
✧ Loss of bone mineral density
✧ Fluid retention
✧ Bleeding gums
✧ Rectal bleeding
✧ Elevated triglyceride levels
✧ Seizures
✧ Decreased night vision
✧ Severe skin reactions

People allergic to isotretinoin can experience:

✧ Skin rash or hives
✧ Itching
✧ Breathing difficulty
✧ Unusual swelling of the face, lips, mouth, and the throat
✧ Tightness in the chest

Side effects like severe abdominal pain, diarrhea, rectal bleeding, persistent fever, nausea and vomiting, blurred vision or vision disturbances, allergic reactions, and hearing problems call for immediate medical attention.
Drug Interactions

This medication can interact with certain other drugs, especially vitamin A and tetracycline. As mentioned already, accutane is derived from vitamin A, and so, taking it along with vitamin A supplements can cause an overdose or a buildup of excess vitamin A in the tissues. This can lead to vitamin A toxicity. Other than vitamin A and tetracycline, this medication can interact with corticosteroids and anti-seizure drugs. Accutane users should refrain from donating blood while on the drug, and also for one month after discontinuing it.

About the iPLEDGE Program

With growing concerns about the serious side effects associated with accutane use, a program called iPLEDGE has been started which allows this drug to be prescribed only by the registered and activated prescribers with the program. The drug can be dispensed only by a registered and activated pharmacy with the iPLEDGE program.

All patients, including women of childbearing age, women who cannot become pregnant, and even men can receive the drug only if they are registered with iPLEDGE. Before receiving the drug, the patient has to fill up a consent sheet after being informed about the risks associated with the drug. This program has been started to make sure that pregnant women do not take this drug, or they do not conceive while taking this drug, as isotretinoin can increase the risks of several birth defects.

To minimize the risks of serious side effects associated with accutane, one should disclose all information pertaining to his or her underlying health problems to a physician. If you have a personal or family history of mental illnesses and depression, heart disease, high triglycerides or cholesterol levels, diabetes, liver diseases, asthma, eating disorders, and osteoporosis, then please inform your physician. Before taking this medication, consider to carefully evaluate all the possible risks and benefits associated with it.

Disclaimer: This article is for informative purposes only, and should not be treated as a substitute for professional medical advice.