Should GPs Prescribe Acne Drugs?

Acne is a common condition that affects around 8 in 10 people at some point in their lives, usually between the ages of 11 and 30. In some moderate to severe cases of acne, a drug called Roaccutane can be prescribed. However, a recent article by the BBC highlighted concerns over the medicine and its potentially serious side-effects.

Though many people who take Roaccutane have a positive experience, others have reported feeling depressed or having suicidal thoughts. As a result, some are campaigning for the NHS to ban Roaccutane despite the drug being approved by regulating bodies.

About Roaccutane

Roaccutane is the brand name of isotretinoin, a prescription-only acne drug used to treat skin conditions. It’s usually only prescribed in cases of moderate to severe acne after other treatments haven’t worked. It can only be prescribed by a specially trained GP or dermatologist.

A course of Roaccutane usually lasts for 16-24 weeks, and patients will often see their acne worsen in the first few weeks before the condition of the skin is improved.

How acne drugs benefit patients

Around 30,000 people are prescribed Roaccutane in the UK every year. The majority of patients have a positive experience with the drug and don’t report any serious side effects.

Roaccutane can improve acne by:

  • Reducing the amount of sebum produced
  • Preventing follicle pores from becoming blocked
  • Reducing bacteria on the skin
  • Reducing redness and swelling in and around spots

Around 9 in 10 people report significant improvement in their condition with a typical 16-24-week course of acne drugs.

Risks and side-effects of acne medication

Like most medicines, acne drugs have a number of potential side-effects. Patients who take Roaccutane may experience one or more of the following:

  • Dryness, inflammation and cracking of the skin, lips and nostrils which can lead to skin infections and nosebleeds
  • Inflammation and irritation of the eyes and eyelids
  • Skin sensitivity and peeling
  • Changes in blood glucose levels
  • Blood in urine
  • Temporary hair thinning
  • Joint and muscle ache
  • Issues with vision, particularly the ability to see at night

Some of the drug’s rarer side-effects include kidney disease and inflammation of the liver or pancreas, although regular blood tests before and during treatment can monitor the risk of these occurring. Other rare side-effects reported by patients include erectile dysfunction and low libido.

Roaccutane is also harmful to unborn children and can cause serious birth defects. Therefore, it should not be prescribed to women who are pregnant or breastfeeding.

Acne drugs and mental health

Although uncommon, some patients have reported a change in their mood or behaviour after taking Roaccutane.

These side-effects include:

  • Feeling depressed or anxious
  • Having thoughts of self-harm or suicide
  • Feelings of aggression

However, research conducted by various medical bodies has found no conclusive evidence that these symptoms are caused by taking Roaccutane. The issue is further complicated by the fact that acne itself can make patients feel depressed.

As a precaution, GPs should advise patients of these potential side effects before prescribing acne drugs. They should check whether or not relatives have a history of depression or other mental health conditions. GPs should also encourage patients to get in touch immediately if they experience any of the above side effects. Patients taking Roaccutane should be monitored through regular follow-up appointments.

Are acne drugs safe to prescribe?

While Roaccutane can be an effective acne treatment for many patients, its side-effects and risks should always be taken into consideration.

GPs are advised to decide whether prescribing the drug will benefit the patient on a case-by-case basis while informing patients of the potential risks.

You can find out more about topics like skin conditions and mental health by reading more from the EBPC blog.