Iso is a prescription medication that may be prescribed for severe acne. Previously sold under the brand name Roaccutane, it is a vitamin A derivative belonging to the retinoid group. The medication was introduced by the Swiss company Hoffmann-La Roche in the early 1980s and has been shown to impact the four primary causes of acne.
Since Iso increases skin cell turnover, it helps minimize the genetically predisposed hyperkeratinization in the sebaceous glands. Additionally, it reduces the size of the sebaceous glands, which both decreases sebum production and lowers the presence of the acne causing skin bacteria Cutibacterium acnes. Besides starving the bacteria of its food source, Iso also has a strong anti-inflammatory effect. It may sound promising, but unfortunately, there is a serious downside.
This medication is one of the few scientifically proven treatments for extremely severe forms of acne. However, it comes at a high cost. Iso can cause very severe and in some cases, permanent side effects. It can only be prescribed by licensed dermatologists and is generally considered a last resort when no other treatment works.
The main issue with Iso is that it is non-selective, meaning that it does not only target acne but affects many other processes in the body. Common side effects include dry, fragile, and light-sensitive skin, dry mucous membranes, chapped lips, dry eyes, depression, hair loss, and gastrointestinal problems. As a fat-soluble compound, it breaks down slowly in the liver and remains stored in body fat for an extended period, often weeks after stopping the medication.
Due to the significant risk of liver damage, alcohol consumption is strictly prohibited while taking Iso, and regular blood tests are required to monitor liver function. Since Iso can also cause severe birth defects, it is crucial to avoid pregnancy while the substance is still in the body. Therefore, fertile women are required to use at least one, preferably two, forms of contraception before, during, and after the treatment.
Iso works, but it is by no means a miracle cure that permanently eliminates acne. It often takes several months of use before any positive effects are noticeable, and acne symptoms usually worsen before they improve. Some people experience no improvement at all, and many see their acne return after the treatment ends. The risk of side effects is high, and while permanent damage is rare, there is no guarantee of avoiding complications.
Unfortunately, many people expose themselves to these risks unnecessarily. Iso is often recommended as a "last resort" in the late teenage years, a time when acne is likely to decrease naturally. This can create the false impression that the medication has "cured" the problem when, in reality, the skin may have healed on its own with a little more time. Before deciding to take Iso, it is crucial to fully understand what the decision entails and carefully consider other, less invasive alternatives. Customized skincare is not only gentler on the skin but often provides the best long-term results.
