Why Pregnancy Is of Concern for Women Taking Accutane

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Accutane is a medication that was used to treat severe acne. Though now it is known as isotretinoin and also marketed as Claravis, Sotret, and Amnesteem. This oral medication is taken once or twice daily to help decrease acne, usually in teens and young adults.

This age group is the very core of the childbearing age potential. The problem is that Accutane or isotretinoin can cause severe birth defects. The medication is so teratogenic that even one dose can cause major problems.

People who wish to take this acne medication must use two methods of birth control for one month prior to treatment, the entire 16- to 20-week treatment cycle, and one month after treatment in order to prevent pregnancy. This is because a potential pregnancy would be at grave risk of life-threatening birth defects.

Why the IPledge Program Is Required for Those Taking Accutane

To combat these risks, the manufacturers came up with the IPledge program. This is for everyone who takes isotretinoin. This program includes separate requirements for women and men. Even if you are a woman who can't get pregnant, such as someone who has had a hysterectomy, you still have to participate in the IPledge program.

Some of the requirements, other than birth control, include monthly pregnancy tests during treatment, prescription parameters, etc. There are several reports that this system is not working as well as had hoped. While birth defects are down, there are lower numbers of people taking medication as prescribed. 

If you are considering pregnancy or are pregnant, this medication is not the medication that you would want to use to try to deal with your acne or skin breakouts. You would need to decide whether the 16-20 week course of treatment was worth the wait, if you were not yet pregnant, or if you would do it after pregnancy.

What Happens if You Take Isotretinoin While Pregnant

About 42% of infants born after being exposed to isotretinoin while pregnant had some form of birth defect or died. Of those infants who had Accutane birth defects, we saw both "internal and external abnormalities such as cleft palate, missing ears, facial dysmorphism, and central nervous system malformations."

The pregnancy labeling category for when Accutane was available was Category X. This means that there were known deformities due to the medication and it should not be taken during pregnancy. There is also information that in the month or two after stopping isotretinoin, pregnancy is also at risk.

Alternatives to Accutane

While Accutane is not available right now, Isotretinoin is available. Neither of these is good while pregnant or planning a pregnancy in the close future. So, what can you do about severe acne?

There are alternatives that can be used, which ones would depend on if you were pregnant or planning a pregnancy. This is a discussion to have with your dermatologist and potentially as a part of your pre-conceptional health visit with your obstetrician or midwife.

What to Do About Acne During Pregnancy

While your skin may give you a run for your money in pregnancy by giving you more acne than you've seen since high school, using Accutane isn't the only option you have to combat tough skin issues. Here are some helpful hints:

  • Wash your face at least twice a day.
  • Wash and change your pillowcases once a week.
  • Use oil-free makeup products.
  • Remove all makeup from your face at the end of the day.
  • Go makeup-free when possible.
  • Find over-the-counter products that are safe in pregnancy. Your doctor or midwife can help you.
  • Stay well hydrated.
  • Good nutrition will help your skin overall.

In the end, you will be glad that you either waited to treat your acne until after your baby was born, or that you delayed pregnancy until after your treatment was finished. This is the best for you and your pregnancy.

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Article Sources
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