My Case With Accutane

by Laura Turner Garrison

“Have you or a loved one ever taken Accutane?”

These ambulance-chasing infomercials sound like a total sham until they suddenly apply to you.

“Have you or a loved one ever taken Accutane?”

My ears were still half-tuned out when I realized, why yes, yes I had.

“Then you may be eligible for a large sum of money.”

Go on…

“Accutane has been proven to cause serious side effects such as Crohn’s Disease, Ulcerative Colitis, and Irritable Bowel Syndrome.”

Oh.

“And you may be owed damages.”

Go on…

In economic times like these, I’m not above a shameless lawsuit to make my millions. Unfortunately, at worst my bowels are unpredictable and there’s no way to argue otherwise. While I’ll sue willy-nilly for a seven-zero paycheck, I am above flat out lying — for the sake of everyone involved. I once dated a guy who had ulcerative colitis and having, um, witnessed it first hand I can say with full confidence it’s not a disease I want to fake.

But despite the disappearing promise of newfound wealth, I was transported to a time in my life I had all but since forgotten. The time when I took purported miracle drug Accutane.

You see, I had acne. Scratch the past tense. I still get breakouts. But as a tweenager, I had chronic acne. The kind that consistently replenished your face with a nice sheen. The kind that spread to your back, your chest, and any place you sweat, which with hormones like mine, could really be anywhere. The kind where popping a zit turned into a three-hour surgery. The kind that rebuffed the advances of Differin, Tetracycline, that shimmery white cream that smelled like cheese, and every other topical/oral combination prescribed by dermatologists. And when you had this kind of acne, all roads eventually led to Accutane.

Accutane is a brand name for the medication known as isotretinoin. It was originally used as a cancer treatment, but Gerald Peck and his colleagues at the National Institute of Health discovered it also worked on severe acne. The drug company Roche acquired the patent for the drug and began selling it as Accutane in the United States in 1982, then in Europe as Roaccutane in 1995. The drug is a retinoid, which basically means it’s a massive dose of Vitamin A. According to Drugs.com, it works to “reduce the amount of oil released by oil glands in your skin and helps your skin renew itself more quickly.”

The bacterium that causes acne actually lives in the oils your skin produces, so if there is less oil then there is less bacteria. Acne.org claims that 95% of people who take Accutane find their acne effectively cured. For life. Do you believe in miracles?

While I haven’t had a bad acne episode since my time on Accutane, I still get zits and probably will until I’m old and gray. Sorry, boys. But for all intents and purposes, this drug fulfilled its miraculous promise. So why doesn’t everyone take Accutane if it’s so darn effective, you ask?

Because, simply put, shit will fuck you up. When I took a regiment of pink, yellow, and brown capsules back in 1999, the ulcerative colitis and Crohn’s risks weren’t even on the radar. And still, the known side effects were very serious. Apparently, high doses of Vitamin A can be terrible for your liver. Anyone taking Accutane was required to get monthly blood work done to ensure their liver was preserved for more conventional damage — like binge-drinking in college.

If you were a woman, you had to sign a waiver promising you were not pregnant and would not become pregnant during the course of your treatment. As an acne-riddled 14-year-old this was not a problem for me. But in case you were tempted to conceive, the drug manufacturers included a graphic illustration of a deformed fetus with the drug information found inside of each box.

In 2006, a birth-defect prevention program called iPledge was launched, and it required all female patients wanting to take Accutane to register on the iPledge website. Registrants had to agree to monthly pregnancy tests along with their regular blood work, and commit to using two forms of birth control while on the pill. Unsurprisingly, iPledge was not without its critics and was ultimately not very successful.

And then there were the suicidal tendencies. Accutane was long associated with depression. Made sense. Any drug that powerful was bound to interfere with some chemicals. In fact, when I first went on Accutane I had difficulty with mood swings and my doctor ultimately reduced my dosage. I had other friends who struggled with more serious depression while on the drug. In 2000, a Congressman’s son committed suicide while on the medication, prompting a surge in research on the relationship between isotretinoin and suicide.

In addition to the more serious side effects, the cosmetic effects were no walk in the park, either. Some patients became highly sensitive to bright light, your skin became a magnet for sunburn, and, most famously, it dried everything out. Nearly everything on your epidermis would flake: face, arms, scalp, lips. I already sweat excessively, I had braces, and now I had a light dusting of snow all over my body. The course of tween years never did run smooth.

Thanks to Accutane, 12 years later I still moisturize obsessively. Step into my bathroom and you will find an apothecary of creams, lotions, and salves.

Of course, all of this is kind of moot. In my revisiting of Accutane I discovered the drug was actually discontinued in 2009. After settling a $33 million lawsuit that year, Roche decided to cut its losses and stop selling Accutane in the United States. But don’t worry, they still sell Roaccutane in other less-regulated parts of the world. Plus, Roche’s patent expired back in 2002, so generic isotretinoin is still available in the United States from other manufacturers. Long live the miracle drug!

On the one hand, Accutane saved me from one of the more painful aspects of puberty. On the other hand, good lord what did I put in my body? In spite of the mountain of downsides, part of me feels like a member of a secret society that today’s teens, as well as many of my peers, will never understand. Accutane was my five-mile walk to school barefoot in the snow uphill both ways.

I remember one time after a drama class — I wasn’t doing myself any favors back then — trying to discreetly pull a yellow capsule out of my backpack. A classmate immediately noticed, but not in a quizzical way. His eyes lit up with instant recognition and we exchanged a knowing nod. This may have been the only time having acne made me feel a part of some special club. A feeling of belonging. Isn’t that what every kid wants?

You know what every adult wants? An inflamed colon so she can sue for millions.

Laura Turner Garrison is a freelance writer and producer living in Brooklyn. She shares her thoughts and work sparingly here.