I’ve recently been put on the drug and I think it would ease my mind if I knew how it actually worked.
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It is basically vitamin A on steroids. Vitamin A speeds up skin cell turn-over, which, in turn, prevents the buildup of naturally-occuring oils and dead skin cells that can cause acne. The downside is that cell turn-over becomes so rapid that your skin, mucous membranes (lips, oral cavity, tongue, gums, anus, labia minora and vaginal canal (if you have female genitalia), and glans (if you have male genitalia), and eyes can become extremely dry due to reduced oil production.
Liver side-effects are due to the fact that vitamin A builds up in your body. As a fat-soluble vitamin, you cannot get rid of excess vitamin A by urination/defecation, like you can with other vitamins. Too much vitamin A can cause really serious liver issues due to toxicity.
Accutane use in pregnant persons causes excessive cell death in very important neurons (nervous system cells) in the developing embryo’s neural crest (the part of the embryo that will form the brain, spinal cord, and nervous system).
The only validated permanent side effects I could find were death and loss of vision, both due to increased intracranial pressure (basically the pressure inside your skull becomes too high and causes your brain to herniate (move where it should not go) into the space where the spinal cord canal begins, at the base of the skull). These side effects are **extremely rare**. Accutane use in combination with tetracycline drugs may coorelate with an increased risk of increased intracranial pressure. Accutane, as noted above can cause vitamin A toxicity (also known as Hypervitaminosis A), which can impact multiple organ systems, including the brain.
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