London, England: Although Accutane is banned in the US – Roche removed its acne drug from the market in 2009 after settling millions of dollars in damages to Accutane inflammatory bowel claimants – it is still available in many other countries. Prompted by a number of suicides, the UK may also ban the drug after the government reviews its risks and benefits.
(Isotretinoin, which is a synthetic retinoid and a form of vitamin A, goes by several names including Accutane in the US and Roaccutane [made by Hoffman-La Roche] in the UK. Generic forms of Isotretinoin, however, are still available in the US since Roche’s patents for Isotretinoin expired in 2002. And the generic acne drugs are cheaper.)
Several family members of suicide victims in the UK – at least three suicides in 2012 were blamed on Roaccutane – have recently protested at Roche headquarters (its corporate company is in Switzerland but the global healthcare company has more than two dozen manufacturing sites and many offices worldwide). In the US, however, Accutane has been linked to suicide ideation and psychopathology for a number of years.
One doctor in Ireland (name not given) is defending Roaccutane. In a letter to the editor of Kerryman (April 23, 2014), its author says, “If Roaccutane was banned it would be disastrous for the small group of people who have very severe acne where nothing else will work. The acne support group in the UK reckon far more people suffer from depression and suicidal thoughts as a result of their acne, not their treatments….For the majority of my patients, their biggest regret with ‘Roaccutane’ is that they did not take it earlier.”
At the same time, the writer acknowledges that Isotretinoin is a very powerful drug and Accutane birth defects are “well known.” And it goes on to advise that acne patients need to be screened for signs of depression before starting the drug. If only dermatologists and other prescribing doctors had the time and/or inclination to do so…
One Accutane victim wishes her doctor had time to explain Accutane side effects. “Doctors…should tell their patients about potential side effects; they should take the time to talk to their patients,” Valerie says. “If my doctor only took five minutes to read about Accutane side effects and give me the option, even though I was probably vain in my 20s, I wasn’t naive.”
In the Kerryman letter to the editor, the writer cited a 2008 review that concluded the link between suicides and severe depression has not yet been clearly demonstrated, which was based on clinical studies and case reports. And given the fact that 13 million patients have used “Roaccutane” since it was approved in 1982, the number of suicides linked to the drug is rare.
Interestingly, the doctor doesn’t mention Accutane Ulcerative Colitis and other bowel diseases linked to the drug. The letter goes on to say that all Roaccutane patients get dry lips, dry nose and dry skin, and more serious side effects are rare. Not so, according to the manufacturer, who has paid more than $53 million to settle Accutane lawsuits.
We have just passed our 2 year anniversary from the introduction of SGA into our Clinics and we have now treated over 6,000 clients with acne and breakouts with SGA. We have learnt that the number of treatments required to bring acne and breakouts under control is higher than we first anticipated. If you come to one of the Clinics today for your acne consult, you will be advised that it will take 8 – 10 treatments to see a significant improvement in your skin. Some clients need less, some clients need more, but 8 – 10 treatments is the average, so patience is a necessity!
Here are some more fantastic before and afters:
I am posting a review that the mother of one of our clients posted to our Facebook page. It really sums up what a huge difference SGA can make to acne sufferers’ lives:
At first I was very cautious as we had tried everything for Chelsea’s skin, so many things, so this really was my last shot for her as I would not have known what to do next. It has taken about 7 treatments if I recall so far but she is finally going to school without makeup. She hasnt done that in years. Always put a lot on to cover her acne, scarring, outbreaks and then been bullied some more for being a “cake face” or other names kids like to call others who struggle with acne. My heart bled for her when she told me she was injuring herself because she couldn’t take the bullying anymore and she hated her skin. Well since starting this treatment I have seen a different person emerge, a beautiful confident young lady and I can not thank you enough for providing this service in Perth that has been able to give her that lease of life back she deserved. I have taken your brochures to promote what you do to the Drs at the surgery who were unaware of what you offer. If we can help one more person become aware of you and help them, then this journey has been well worth it. No more Drs, medications, ointments, crap skin products that promise miracles because they are endorsed by this or that celebrity which then fail to live up to the hype but rob you blind. We see that light at the end of the tunnel. I am certainly bringing my son in should he get skin like she had.
I wanted to share this post from fashion editor Sophie Eggleton about her adult Acne. Adult Acne is such a huge problem, particularly women and yet it is rarely written about. Good on her for sharing her experience.
The Diary of a Hermit: Adult Acne
As I write this it’s 7am and I already know I’m going to have a bad day.
Aside from checking my phone for notifications, and slamming the snooze button, the first part of my morning routine is looking in the mirror – one that I keep right by the bed or even under my pillow. This one look will be influential enough to encourage or hinder my getting out of bed and facing the day.
This morning I’m greeted with large swollen lumps on my cheek, pustules dotted across my jawline, and a painful third eye bulging out from my uni-brow – after surveying today’s canvas I slumped back into the pillow.
I’m nearing the end of my twenties, this was meant to end a decade ago!
The physical and mental scarring began when I was twelve, a horrendously insecure age for anyone, but also the year some little oik publicly used my spots as a reason not to go out with me on a first generation social media site. But however distressed I got, I was always comforted by the fact, or myth, that as soon I turned twenty, and my teen years were behind me, that my skin would be clear like the actresses in the glossy fashion magazines and my enviably zit-less friends.
Thanks in part to my body’s intolerance to all foods I choose to consume, my face is always etched with some visual evidence of my allergies. On particularly angry days I want to stay inside – out of sight of all humans and their possible judgements. I make sure the curtains are drawn, as if I’m in the full glare of daylight (reality) I tend to repeatedly mentally ridicule my face in all reflective surfaces.
Unfortunately, a dodgy skin day is not a legitimate excuse to abandon work duties, despite its capability to drastically affect performance. I regularly curse the career path that’s landed me as a video-blogger. As a female interviewer, particularly one that talks to a lot of male musicians, I suppose I’m exposed to more criticism than if I had a more ‘normal’ job. Every time I post a new interview I fear/expect a scathing or cruel response from the notoriously uninhibited YouTube comment makers. I feel for celebrities and the level of scrutiny their looks and skin are under. I’ve always thought ‘The Circle of Truth’ type articles highlighting their supposed flaws (Cameran Diaz’ acne problem for example) were a grossly unfair part of their chosen career. On a positive note though, I found it hugely comforting that these renowned beauties weren’t perfect – they too suffered with this unsexy problem.
As well as affecting my confidence when interviewing – less eye contact, bad posture, barely looking at the camera – acne has affected other areas of my life…
My hair has always been long – apart from a failed attempt at the Meg Ryan choppy bob (City of Angels era) which turned my barnet into some sort of mushroom. Yes, it’s feminine and versatile, but the main reason behind my hairstyle is its usefulness as a natural veil. On really bad days it’s draped lankly over my face like one of those crystal beaded curtains found in launderettes. Beanie hats are also a vital apparatus used to help disguise the outbreaks on my cheeks, helpfully clamping my hair over my the problem areas – wholly necessary for blustery days. If only Balaclavas were on trend this A/W!
But acne doesn’t just affect those inflicted. Over the years my poor boyfriends have had the impossible task of minimising my anguish, when sunscreen has turned my face into something resembling lasagne for example. They’ve also had to put up with me ducking under the duvet to hide my blotchy, make-up free face every morning. Making excuses not to attend social events because I don’t want to be photographed next to the beautiful people blessed with minute pores is also common place. The prospect of having to abandon my skincare regime and reveal my bare face to others at festivals or sleepovers has always caused extreme anxiety too. It really is endless..
Of course there are many parts of me that I’d like to change, but most can be enhanced/minimised with the use of clever dressing, working the right angles…or exercising (never going to happen). Make-up can cover up redness and scar discolouration pretty well, but it can’t hide undulation or valleys, and you can’t predict when those pesky white heads will show up!
Hopefully one day I’ll won’t feel the need to sharply change route if I see someone I know on the horizon, or keep moving my face frantically when conversing to give the illusion of pixelation or airbrushing…..In the meantime, just a few things. When you say how you prefer natural girls please remember that some of us would love to go bare faced, we just can’t. When a professional explains that men naturally want to mate with women who have good skin…that really hurts. And If you tell us it doesn’t look that bad, we won’t believe you.
It’s not JUST spots… to us it’s a nightmare.
Follow Sophie Eggleton on Twitter: www.twitter.com/SophieEggleton
If you would like a free online consultation with me, all you need to do is email me at firstname.lastname@example.org
Please provide me with the following information:
Your name, age, suburb and state
How long you have had acne and breakouts
What products and treatments you have tried ( please include any pharmacy or medical treatments ) What’s worked, what hasn’t
For female consultees – please tell me if your periods are regular or irregular, heavy or painful
Please attach three clear photos of your face, front on and each side of your face.
All this information is going to my private email account and will be kept confidential.
Please allow 5 days for me to answer your email.
I look forward to hearing from you soon.
I am really excited to tell you that within one week, my new free, online Acne Consultation service will be up and running. I have had a dream of offering this service for a long time, as I have been offering online consultations for my Clinics for a number of years. I have been inspired by an American website called Yo Derm ( agree, terrible name ) which is offering online Acne Consultations for $59, not so much for its service, which I think is a little limited ( I believe there is a lot more to managing Acne than giving people prescriptions ), but for its resounding endorsement of telemedicine, which is the name for conducting consultations via mobile, web or email, rather than face to face.
Diagnosis and management of Acne is ideally suited to telemedicine as the physical examination is visual and can be performed almost as effectively via photography.
I am completely passionate about giving every person with Acne the opportunity to clear their skin. This blog was the start of this mission and my online consultation service is the next key step.
So, from October 17th, 2013, you will be able to email me your photos and the answers to a small number of clinical questions and I will email back to you an individualised treatment plan. My next post will have my email address and instructions regarding what information I will need to assess your case.
I have posted some information about telemedicine from the Yo Derm site, which you might find interesting :
Effectiveness of Telemedicine
Telemedicine for dermatology patients is a great tool because skin conditions can be readily examined in digital still or video images,”1 said Armstrong, who also serves as director of the health system’s teledermatology program. “Our study found real and beneficial differences in the vast majority of teledermatology cases we analyzed,” said Armstrong. “With rapid improvements in interactive mobile platforms, connectivity speed and visual clarity, telehealth services like dermatology will play a bigger and bigger role in improving the quality of care and the access to specialty services that people deserve no matter where they live.”1
April Armstrong, M.D.http://www.ucdmc.ucdavis.edu/publish/news/newsroom/6127
Benefits of Telemedicine
“(Teledermatology) represents an excellent novel approach to treatment of a huge underserved patient group. Many people with moderate to severe acne live in areas without access to a dermatologist and may not be able to afford traditional care or may not even be aware that effective treatments are available. By using modern technology, acne treatment can be delivered remotely to this population to provide significant medical as well as psychological benefits at a significant cost savings.”
James Clint Jones, M.D.
“(Regarding teledermatology) In addition to increasing efficiency, the technology is a boon to patients and primary care providers seeking consultation, particularly those in medically underserved or remote areas. Travel time to a dermatologist is eliminated and there is no waiting.”2
California Healthcare Foundationhttp://www.chcf.org/publications/2009/12/storeandforward-teledermatology-applications
“Patient satisfaction with care received through teledermatology was equivalent to that with face-to-face dermatology.”3
Hsueh, Eastman, McFarland, Raugi, and ReiberTeledermatology Patient Satisfaction in the Pacific Northwest
Effectiveness of Online Acne Care
“Delivering follow-up care to acne patients via an e-visit platform produced clinical outcomes equivalent to those of conventional office visits.”4
Watson, Bergman, Williams, KvedarA Randomized Trial to Evaluate the Efficacy of Online Follow-up Visits in the Management of Acne
Coming up to 18 months since we started offering SGA in our Clinics, we have learned a lot about the expectations we should be setting for our new SGA clients. We know now that just about everyone who has SGA will experience improvement in the amount of breakout they experience, when they have a series of SGA treatments. We also know that clients will experience optimal results if they have SGA in combination with a follow up skin peel and LED light therapy one week after their SGA treatment. We also know that some clients will need at least 6 to 10 SGA treatments to see a significant improvement in their breakout and that there are some female clients with very treatment resistant acne, who will require treatment for longer periods to achieve breakout free skin. But for me, the most satisfying aspect of introducing this new treatment, has been the number of clients who had been liberated from the burden of chronic acne and are finally enjoying their lives to the full, without having to worry about when they will get their next breakout.
We are opening our first Clinic in Auckland New Zealand in the next few weeks and are actively working on our strategy to take SGA to the rest of the world.
It’s coming up to twelve months since we started doing SGA in all our Clinics. In that time we have treated over 3,000 people with Acne & Breakouts and we have learned a lot about the time it takes to see significant control of breakouts and clear skin emerge. Whilst it is always difficult to generalise, we believe that SGA is at least a six month commitment ( at the rate of one treatment per month ) and for some people with really stubborn breakouts, 12 months, to see that significant improvement. One of the challenges for our therapists for those clients that are slow to respond to SGA, is keeping them from giving up. It is one of the sad facts of Acne & Breakouts that there are a lot of treatments that promise to deliver clear skin, but very few that actually do. This means that our clients are very sceptical about SGA’s ability to deliver clear skin for them, unless they see immediate results. My job with this blog is to keep presenting the evidence that SGA is different and break through that scepticism that abounds in the minds of people with chronic Acne and breakouts. SGA will permanently eliminate your Acne and Breakouts, if you give it a chance.
I have read four articles in the past week describing research into bacteria and viruses that interact with the P acnes bacteria on the skin and their potential to deliver a future “Acne Cure”. I can’t help feeling like Sallah in Raiders of the Lost Ark..”Indie, Indie, they’re digging in the wrong spot”. Too attention is paid by researchers, inaccurately in my opinion, to P acnes, which is not the cause of Acne. The role of P acnes in the Acne story is secondary to the malfunctioning of the sebaceous gland. If the sebaceous glands are functioning properly, P acnes is never a problem. After all, it is part of our ” normal” skin flora, the bacteria and viruses that live on our skin that act to help protect the skin from infection. In the malfunctioning sebaceous gland however, P acnes goes haywire, causing inflammation that leads to the formation of pimples and cysts.
Therefore, all our attention needs to be focussed on getting rid of the malfunctioning sebaceous glands. Enter Sebaceous Gland Ablation- SGA. SGA is the only treatment that focusses on eliminating the cause of Acne, the malfunctioning sebaceous gland, leading to permanently breakout free skin. In the Acne puzzle, SGA is the answer.
Here is a video by Maggie who has had great success with SGA to control her breakouts and fractional RF resurfacing to help her Acne scarring.