Acne Medication: Knowing How to Take It Makes It a Remedy, Not a Poison

Hello. I am Dr. Lee Sang-ju, a dermatologist. Medication plays a very important role in acne treatment. If it's not intractable acne, most acne concerns can be resolved with an appropriate prescription from a dermatologist. However, if you know how to take acne medication, it can be a remedy, but if you don't, it could be a poison for some. Today, I will provide detailed information about acne medication, which many people are curious about. Please be sure to watch this video before getting an acne medication prescription.

To get straight to the point, no. Acne varies from person to person, so in some cases, antibiotics are used, and in others, sebum regulators like isotretinoin are prescribed. Therefore, the idea of solving all acne problems solely with the sebum regulator Roaccutane (now replaced by generic drugs) is incorrect.

• Isotretinoin (formerly Roaccutane)

  • Main ingredient: Isotretinoin
  • Action: Reduces sebum secretion, drying out the oil glands that cause acne.
  • Primary use: Primarily for moderate to severe acne, especially inflammatory acne that does not respond well to other antibiotics or topical medications, it is known to have excellent therapeutic effects.
  • Onset of effect: The effect does not appear immediately after taking the medication; it usually takes about 4 to 6 weeks of sufficient intake to see results.

• Antibiotics

  • Primary use: Mainly used for inflammatory acne, such as red acne.
  • Main drugs: Tetracycline-based antibiotics are primarily used.
  • Action: In addition to antibacterial action, it is also effective in reducing overall inflammatory reactions caused by acne, making it effective for treating red acne.

It depends on the type of surgery. If you are undergoing major surgery while taking sebum regulators, you must consult with your doctor before the surgery. This is generally because sebum regulators, which affect sebum secretion in the pores, can slow down or delay wound healing.

However, recent research suggests that if you are taking a small amount, such as one or two pills a day, relatively minor procedures like hair removal lasers, vascular lasers, or fractional lasers can be performed without significant issues.

Antibiotics and sebum regulators are different. Antibiotics can cause resistance. Therefore, the American Academy of Dermatology recommends using antibiotics for 6-8 weeks and not for longer than 3-6 months. However, this is a guideline, and the duration of medication may vary depending on the judgment of the attending physician. 3 or 6 months are not absolute periods.

On the other hand, sebum regulators (isotretinoin) are not antibiotic components, so they are generally not known to cause resistance. In fact, long-term use has been reported to reduce acne recurrence. Especially when taken for more than 4 months, it helps achieve sufficient effects, and recurrence rates are known to drop significantly when the cumulative dose (120mg/kg) is reached. Effects may persist for a certain period even after discontinuing the medication. However, if this medication is used long-term, regular blood tests, such as liver enzyme levels and blood cholesterol levels, may be necessary.

That is not true. While sebum regulators are effective in treating acne, they can also have side effects. Taking high doses from the start is not recommended. Generally, the dosage of sebum regulators is proportional to the content of the main ingredient, isotretinoin, and you can think of it as being proportional to body weight.

• Initial dose: Start with 0.5mg per kg of body weight per day. (e.g., for a person weighing 40kg, 20mg per day, which is two 10mg pills)
• Gradual increase: Gradually increase up to a maximum of 1mg/kg while observing treatment effects and side effects. (e.g., for 40kg, can be increased to 40mg after one or two months of taking it)

However, in Koreans, side effects may appear more severely than in Westerners, so low-dose therapy is also widely used in addition to general用法. Low-dose therapy involves using less than 0.4mg/kg per day, with about 16mg per day (one or two 10mg pills) being commonly used for a 40kg person. Generally, low-dose therapy is preferred by many people in Korea because it is effective and has fewer side effects. However, to reach a sufficient cumulative dose to prevent recurrence with low-dose therapy, long-term medication may be necessary.

One of the most common side effects of isotretinoin is the risk of birth defects. Isotretinoin is a vitamin A derivative, and since vitamin A is fat-soluble, it can accumulate in the body and cause various symptoms if excessive. Pregnant women or women planning to become pregnant should absolutely not take it. Women of childbearing age should use contraception while taking it. Of course, if you wish to become pregnant, you must stop the medication, and there are no major problems if you plan for pregnancy at least one month later. In other words, there is no risk of birth defects if you become pregnant after stopping the medication for one month, so you don't need to worry too much.

In addition, because it is a sebum-drying medication, it can dry out not only the skin but also the eyes and lips. Occasionally, blood cholesterol or liver enzyme levels may increase, so regular blood tests may be necessary.

There is a common perception that dermatological medications are strong, but this is not actually the case. This perception is often due to antihistamines used to relieve itching. Taking antihistamines can cause drowsiness and lethargy, which sometimes leads to the misconception that the medication is strong. It is not because the medication is strong, but because antihistamines have a side effect of causing drowsiness.

Especially, medications developed for acne treatment often require several months of treatment and long-term medication, so they are made to be relatively safe. That is, they are developed to have no major problems even with long-term use. By choosing the appropriate medication according to the condition of the acne—whether it is inflammatory or non-inflammatory, mild, moderate, or severe—side effects can be minimized and effects maximized.

Today, we have looked in detail at isotretinoin, a representative sebum regulator among acne treatments. If you have any other questions related to acne treatment, please feel free to contact us at any time.