“There is probably no single disease that causes more psychic trauma, more maladjustment between parents and children, more general insecurity and feeling of inferiority and greater sums of psychic suffering than does acne vulgaris.”
– Marion Sulzberger –
Dr. Ginsburg feels acne is one of the most important diseases that he treats. Particularly, because he can clear up a patient’s face 99.9% of the time.
Acne is a common skin condition that afflicts most people in some way during the teen years. However, the disease can occur in any age group. Adults in their 20’s to ’40s may have outbreaks, even if they haven’t before. Do not think that because it is common, treatment is unnecessary. Waiting to “outgrow” acne can be a serious mistake.
Dr. G Discusses: Acne & Accutane
Acne is the most frequent visible skin disease in adolescents, and unlike many conditions, it is not always easy to hide. For this reason, acne often causes problems with self-esteem and affects interpersonal relationships. More severe acne is associated with depression and suicidal thoughts. My goal in treating acne is not only to clear the skin. It is also important to improve the psycho-social impairment that may have resulted. Although acne is a treatable condition, many people still struggle with it. Part of the reason is that they may have tried treatments that did not work.
I believe the most effective treatment, Accutane (isotretinoin), is significantly underused. Accutane is a derivative of Vitamin A and is an incredible drug that has been since 1980. It was first approved for the most severe cystic acne, but over the years it has proven effective at clearing all types, to the point of actually curing some patients once and for all. Not only does it prove to be the most effective treatment, but it is also the safest.
Flashback Friday: Saving Lives by Treating Acne with Diet
Over-activated TOR signaling may help explain the link between acne and subsequent risk for prostate and breast cancer. New subscribers to our e-newsletter always receive a free gift. Get yours here: https://nutritionfacts.org/subscribe/ TOR is considered the engine-of-aging enzyme detailed in Why Do We Age? (https://www.nutritionfacts.org/video/why-do-we-age) and Caloric Restriction vs. Animal Protein Restriction (https://nutritionfacts.org/video/caloric-restriction-vs-animal-protein-restriction/), as well as in my previous video: Prevent Cancer from Going on TOR (https://nutritionfacts.org/video/Prevent-Cancer-From-Going-on-TOR). I’ve touched on this topic before in Acne & Cancer Connection (https://nutritionfacts.org/video/acne-cancer-connection/), and I covered acne and dairy in: Skim Milk & Acne (https://nutritionfacts.org/video/skim-milk-and-acne/) National Dairy Council on Acne & Milk (https://nutritionfacts.org/video/national-dairy-council-on-acne-and-milk/) The Acne-Promoting Effects of Milk (https://nutritionfacts.org/video/the-acne-promoting-effects-of-milk/) Urologists saving the lives of men is detailed in Survival of the Firmest: Erectile Dysfunction & Death (https://nutritionfacts.org/video/survival-of-the-firmest-erectile-dysfunction-and-death/) and 50 Shades of Greens (https://nutritionfacts.org/video/50-shades-of-greens/). I recently released a few new videos on acne. Check out Does Chocolate Cause Acne? (https://nutritionfacts.org/video/does-chocolate-cause-acne/) and Does Cocoa Powder Cause Acne? (https://nutritionfacts.org/video/does-cocoa-powder-cause-acne/). There’s also Natural Treatment for Acne & Fungal Infections and Benzoyl Peroxide vs. Tea Tree Oil for Acne (https://nutritionfacts.org/video/natural-treatment-for-acne-and-fungal-infections/ and https://nutritionfacts.org/video/benzoyl-peroxide-vs-tea-tree-oil-for-acne/). Have a question about this video? Leave it in the comment section at http://nutritionfacts.org/video/flashback-friday-saving-lives-by-treating-acne-with-diet and someone on the NutritionFacts.org team will try to answer it. Want to get a list of links to all the scientific sources used in this video? Click on Sources Cited at https://nutritionfacts.org/video/flashback-friday-saving-lives-by-treating-acne-with-diet. You’ll also find a transcript and acknowledgements for the video, my blog and speaking tour schedule, and an easy way to search (by translated language even) through our videos spanning more than 2,000 health topics. If you’d rather watch these videos on YouTube, subscribe to my YouTube Channel here: https://www.youtube.com/subscription_center?add_user=nutritionfactsorg Thanks for watching. I hope you’ll join in the evidence-based nutrition revolution! -Michael Greger, MD FACLM boyloso / Adobe Stock. This image has been modified. Captions for this video are available in several languages; you can find yours in the video settings. https://NutritionFacts.org • Subscribe: https://nutritionfacts.org/subscribe • Donate: https://nutritionfacts.org/donate • Podcast : https://nutritionfacts.org/audio • Facebook: www.facebook.com/NutritionFacts.org • Twitter: www.twitter.com/nutrition_facts • Instagram: www.instagram.com/nutrition_facts_org • Books: https://nutritionfacts.org/books • Shop: https://drgreger.org
So why don’t we prescribe it for every patient?
We don’t prescribe Accutane for every patient because it can cause severe birth defects if a female gets pregnant while taking it. The FDA developed a program for pregnancy prevention called iPLEDGE. The iPLEDGE program is a mandatory distribution program in the United States for isotretinoin. It is intended to prevent the use of the drug during pregnancy, due to the high risk of birth defects. As of March 1, 2006, patients and their doctors and pharmacists are required by the U.S. Food and Drug Administration (FDA) to register and use a website in order to receive this medication.
Dryness of lips and skin is the most common side effect. Depression is a very rare side effect. For this reason, we monitor your emotional well-being while you are on Accutane. Improvement in your self-esteem and mood is a much more common positive side effect of Accutane. We sometimes monitor your blood for lipid alterations. This is more common in people who have a family history of heart disease or are overweight. Alteration in dosage or dietary changes helps manage rising blood lipids.
Some people attribute Accutane to inflammatory bowel disease. The actual evidence for this is very weak. Interestingly, doctors use derivatives of Vitamin A and isotretinoin to treat cancers and to prevent skin cancers in certain patient populations.
For responsible patients, isotretinoin is the gold standard for the treatment of acne. It is a treatment for any with a high success rate and few significant side effects. I have rarely seen an allergic reaction to Accutane. I have never seen a treatment failure in those that adhered to my treatment plan.
Clear up for Good
Some patients get better immediately. Some get worse, then better, and some take a few months to improve. However, ultimately every patient that I have followed has gotten complete clearance.
Once clear, many patients will stay clear for months to years. In some patients, the acne does not return. The dosage and duration of treatment depend on the severity and the patient’s weight. There can be variation in the initial response, the rare flare-up, and the occasional minor side effects. Because of this, it is very important that a physician very experienced with acne and isotretinoin prescribe it.
Isotretinoin is not suitable for every acne patient. Patients with severe cases or those that have failed antibiotics and topical therapy may consider it.
Unfortunately, too many people misled by lawyers or other groups with conflicts of interest remain unaware of how well isotretinoin works. So, if you have acne, we should engage in an open honest discussion about the best way to manage it. No one should suffer needlessly.
Ginsburg Dermatology Center ACNE segment ABC 33/40
ACNE segment on ABC 33/40 featuring Dr. Barry Ginsburg.