Roaccutane: The miracle acne drug linked to 20 suicides

“Mood swings, depression, anxiety, and thoughts of self-harm and even suicide.” These are all possible side effects of this drug that is being hailed as a miracle cure for acne.

Isotretinoin, or more commonly known in the UK as Roaccutane, is a drug that is commonly used to treat acne, mostly with teenagers and young adults. Its effectiveness is undisputed, as the British Association of Dermatologists (BAD) say that it is effective with 9/10 subjects, with many cases clearing severe acne completely.

Yet there are common and well publicised side effects. According to The Times, there have been 20 cases of suicide related to the drug, whilst the BAD claim it is being administered more regularly. Parents of children like Luke Reeves, Jamie Silcock, and Jack Bowlby have all been vocal about the risks involved with Roaccutane after all three had reportedly committed suicide due to the drug.

The problem is, Roaccutane works…

Roaccutane itself does work and work quite well, as it helps to stop the environment in which acne-causing bacteria can thrive. Most treatment takes around four to six months for the acne to clear, and after this point, most are likely to remain acne clear for a long time after.

According to the BAD to gain access to the drug, you don’t just pay a visit your GP. You have to be referred to a dermatologist who can then prescribe the drug. Even so, the drug does seem to be used as a last resort, with antibiotics, topical creams and other methods first used to try and treat acne.

Patients are asked about their mental state, take regular blood and urine tests that examine liver, kidney, and pancreas function as well as pregnancy tests for female patients. Patients must also sign a document saying that they understand the side effects of the drug. The visits are monthly.

Here is a shortened list of some of the known side effects (the rest can be found on the NHS website):

• Dry Skin, itchiness, cracking of the skin and blotches.

• In Pregnant women and those wanting to conceive are advised vehemently not to take the drug as it can cause major birth defects.

• Inflammation of the eyes.

• Blood in Urine.

• Contraception must start at least four weeks before starting treatment, be used at all times during treatment and for at least four weeks after stopping isotretinoin, even if you don’t have a period.

• Decreased night vision can also occur after stopping treatment and can occur suddenly.

• Convulsions.

• Mood Swings, depression, anxiety, and thoughts about self harm and suicide.

• Inflammation of Kidney.

• Inflammation of liver.

We spoke to the BAD about the links between mental health deterioration and the drug. “We try to make clear to patients that there are rare but serious side effects that may occur on Isotretinoin particularly around mood and changes of behaviour.” They went on to say that  “a dermatologist may discuss your mental health before starting treatment, and if you have a history of depression your dermatologist may ask a psychiatrist to see you before starting Isotretinoin to determine if it is safe for you to take.”

With a list of side effects like that, some may ask why are people taking Roaccutane? We spoke to students who have taken the drug to reduce their acne, and the effect it had on their lives. Each person mentioned shows a very different encounter with the drug, all were successful in treatment, while the extent to which side effects took place did differ.

Molly Geddes, 20, Cardiff: ‘It completely restored my confidence’

People would always say to me ‘your skin isn’t even that bad!’ To me, it was like the worst thing in the world, I was so self-conscious about my bad skin and I had been for YEARS! I started going to the doctors when I was about 13 and over the years I tried every cream, tablet, vitamin, and pieces of advice they had to give me. I had slight scarring so eventually when I was about 16 they referred me to the dermatologist at my local hospital.

When I started taking it, the effects kicked in pretty quickly, but also my skin started getting much better! The worst side effect I had, wasn’t anything to do with my moods, but the dry skin it caused (and horribly crusty lips). I was on a 6-month treatment, and although at the time it felt like forever, looking back I barely remember it. I had to have a blood test taken to start with, a urine sample (which I had to provide every time I went for more doses) just to check you were healthy enough to take it (to prove I wasn’t pregnant for example). I also had a huge risk talk before I was given them about the things I could and couldn’t do, for example, I was warned my skin would be so dry that if I tried to wax my body hair it would tear my skin off!!  I didn’t seem to get any noticeable emotional or mental side effects, just physical dryness.

It completely changed my life. I know that sounds dramatic, but it completely restored my confidence and made me feel amazing.

Lydia Rose Stephens, 20, Cardiff: ‘My lips were constantly cracked’

I first began to get spots at the age of 10, but it wasn’t until I was around 12 or 13 that it really started to get aggressive. I had spots on my face, chest and back, which left me feeling insecure. My GP prescribed topical creams and ointments which didn’t seem to work, I was then given the antibiotic Amoxicillin which is designed to fight the bacteria that causes spots, but it didn’t have a great effect. After a few trips to the GP, I was referred to a dermatologist that specialised in the drug Isotretinoin (Roaccutane.)

You can’t just walk into a GP’s office or dermatologist office and demand for this treatment, it took years of failed treatments and a long waiting list to be considered. After taking the medication for roughly six to nine months my acne on my back, chest and face cleared.

The most immediate side effect that I suffered whilst taking Isotretinoin was dry and hypersensitive skin. My lips were constantly cracked (shown in the picture above), I had nosebleeds from the dryness inside my nose and my skin was easily susceptible to sunburn. Before taking the drug, I had to have blood tests and urine samples to ensure my liver and immune system were functioning correctly. They were also very picky with mental health due to the hormonal nature of the treatment, asking if I had ever suffered with depression before. Isotretinoin can also cause severe harm to unborn babies, so I was also prescribed the contraceptive pill as well as having to have a monthly pregnancy test at the hospital to ensure pregnancy was being prevented.

Unfortunately, I’m one of the unlucky ones whose acne has returned after taking Isotretinoin, so I was prescribed a second course when I was 16. I haven’t had acne as severe since the treatment, but I do suffer from bouts of hormonal acne (situated on my chin and neck) from time to time, but since the treatment, topical creams and cleansers work a lot more successfully than prior to Isotretinoin.

Overall, the treatment was very successful for me.

Georgia, 20, St Andrews: ‘I was 19. Big mistake.’

I first went on Roaccutane when I was 15. My skin would come up in dry blisters the size of my hand. The only thing that would help was baby moisturising cream (for bottoms!) Nothing more glamorous. It improved my skin somewhat. I then went on it again when I was 19. Big mistake. It takes at least 3-4 months to actually get on it from GP appointment to hospital department describing it. Doctors can be quite harsh and one shouted at me to stop to touching my face. It left me very ill and I would not go on it again. It really affected my mood and at times I did get quite low.

It does wonders for some people, but it can really affect your mood and should only be prescribed in low doses and as a last resort.

Billy Grant, 20, Nottingham: ‘I didn’t have the courage to admit I was suicidal’

I remember the first time someone pointed out my acne to me. I walked into my form room at school, sat down and someone said my face was swollen on one side. I hadn’t even noticed but the whole day I couldn’t help looking at my reflection and worrying. When I got home I frantically asked my mum if I could see a doctor. Later that week I started taking Flucloxacillin to deal with the swelling that was happening in the sub-dermal layers of my skin. I saw some results and I thought this was all over. Unfortunately, over the coming month, my skin would get a lot worse.

I remember when he first recommended Roaccutane he simply said: “it will give you results”. I didn’t care about any of the side effects at that point. I was desperate for this nightmare to end. My mum sat me down and warned me that the drug I was about to start taking did have a lot of side effects that might affect my mood and that I should be cautious. As I said, I didn’t care about any side effects at that point. If anything I was thinking how could things get any worse.

I remember waking up in pain every day as my lips were so dry they’d split apart as I opened my mouth in the morning. In the first couple of weeks, your acne does redden and swell up as well. It was about two months in that I noticed a change in the way my mind worked and it wasn’t pleasant. Imagine the feeling of being inebriated all the time. I just couldn’t focus on anything and I found it very difficult to think positively. I received a lot of advice on how to manage my mood, people would keep telling me to stay active and make sure I spend enough time outdoors in direct sunshine. As the days got shorter I found it very difficult to manage my depression.

Looking back I knew that I felt suicidal but I also knew at the time that I would never be able to go through with it. It wasn’t that my life was truly horrible, far from it, I was surrounded by people giving me constant support. It came from a place where I saw no future, I didn’t any point in living anymore. I remember sitting in my GP’s office as he asked me how I felt after a few months on Roaccutane and if I had any suicidal thoughts, I didn’t have the courage to admit I did whilst my mum was sitting next to me, so I just said no. As my course of Roaccutane came to a close in the early months of 2014 I was very ready to stop and thankful that through all the horrible things I had to deal with, my skin finally cleared up.

It was a hard time to go through something like that, but it’s made me the person I am today. To everyone going through the treatment, I hope that they stay safe, stay surrounded by the people who will support you and remember that even though things may seem so bad that it isn’t worth carrying on the future is closer than you think.

This is a shortened version and you read Billy’s full account of his time with Roaccutane here.

Ursula Rifat, 21, Cardiff: ‘Brilliant in small doses’

I took my first course about three or four years ago because I had terrible acne everywhere, especially on my back. I struggled with acne since I was 11, been all through the system with it, kept going back to the doctors and got given creams/pills that didn’t work etc, so when I turned 18 Roaccutane was the last resort!

I took a very low dose, and had minimal side effects and my acne cleared up. I’m going on it again soon though as although I have very clear skin on my face I have quite bad scarring and cystic acne on my back still.I’m not too worried about taking it again as I was fine on it last time.

I think it’s a brilliant drug in small doses which works for lots of people.

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Isotretinoin or Roaccutane is certainly an interesting drug. Most do suffer from acne during their lifetime, and for those that have it particularly bad, could find a solution in Roaccutane. Yet, at this point, no research has been published as to the link between mental health and the drug. The number of prescriptions of the drug is increasing, which the BAD is partly attributing to the fight against antibiotic resistance. Dermatologists and doctors are certainly aware of the adverse side effects, shown by the fact it is so hard to get the drug. But once again it’s effectiveness is undisputed.

So, until more is known about the Isotretinoin and the link between mental health, the jury shall remain out.

If you have been affected by any of the issues raised in the article, consult your local GP for more information.