Accutane - keep it available

Accutane - keep it available
By David F. Jaffe, M.D.

November 29, 2000
Editor, Baltimore Sun
PO Box 1377
Baltimore, MD 21278-0001

Dear Editor,

I am concerned about my patients. Over the years, I have seen more than three thousand acne patients and have treated approximately 15% of these patients with isotretinoin, also known as Accutane. This key acne treatment has significantly improved my patients’ severe scarring acne, and as a result, their emotional well being. If this treatment were not available in our community, it would have a devastating effect on my patients’ lives.
Recently, an advisory panel to the Food and Drug Administration (FDA) recommended restricting access to isotretinoin to only registered physicians and registered patients. This action stems from reports of depression and potential birth defects in women who may become pregnant while taking this medication.
My foremost concern is the safety of my patients. While I share the FDA’s concerns regarding the serious side effects of this powerful medication, it is crucial that I be allowed to offer all treatment options to my patients so together we can make an informed decision. In some cases, isotretinoin is the only effective choice for my patients’ severe, disfiguring acne.
I support the American Academy of Dermatology’s position that education of physicians and patients, rather than regulation, is the best way to ensure safe and effective results when using isotretinoin. Limiting distribution of this important acne medication would severely restrict access to the drug, making it difficult to obtain, especially for patients in rural areas. This action would be an immense disservice to patients everywhere.
Millions of teenagers and adults have acne, a chronic skin condition. Because of its visibility, acne often has a devastating effect on a person’s self-confidence and self-esteem. When severe, untreated acne can result in disfiguring scars.
While over-the-counter products can often control acne in its mildest forms, dermatolologists will frequently prescribe topical medications and oral antibiotics for more difficult cases. In severe cases, isotretinoin is the only medication proven to effectively control resistant nodular cystic acne, the most serious form of this skin disease. Studies have shown that over a 20-week period, up to 80 percent of patients taking this medication will have a complete resolution of their acne, and in most cases, permanent clearing.
Everyone knows someone with acne, whether it’s a neighbor, a co-worker, or a friend. Today, we are fortunate to have access to an extremely valuable medication for the care of destructive cystic acne. The decision whether or not to prescribe this treatment should be made on an individual basis between the dermatologist and his or her patient. It should not be influenced by government regulations.
David F. Jaffe, M.D.