Isotretinoin, available by the name of Accutane, is a common drug to treat acne. However, it has also been associated with several side effects such as liver damage, depression, and birth defects in women who are pregnant.
Derived from vitamin A, isotretinoin works by reducing the size of the sebaceous glands or the production of oil produced. This, in turn, reduces the number of bacteria on the oily skin and decreases the levels of inflammation.
But how does isotretinoin achieve these effects?
Published in the Journal of Investigative Dermatology, this new study tends to explain this mechanism.
How Isotretinoin Works
Dr. McCoy, the lead researcher explained the presence of certain greasy areas on the skin that promote the growth of certain bacterial communities. Some of these communities are observed to be linked with acne.
The team wished to know if isotretinoin was able to decrease such bacteria, such as Cutibacterium acnes, also known as Propionibacterium acnes.
The researchers recruited 17 people suffering from acne who received treatment with isotretinoin. The control group consisted of 8 individuals, four of them with acne and four without it. None of them received the treatment.
The team collected skin samples from the faces of these people four times for 10 months. The main findings indicated that the use of isotretinoin did decrease the number of C. acnes while increasing the diversity of bacteria on the skin.
According to Dr. McCoy, isotretinoin made the skin less-hospitable to these acne-causing pathogens.
The team used targeted metagenomics to found that isotretinoin also increased different other forms of bacteria which had no previous link with acne improvement.
As per the research team, the findings of this latest study show that isotretinoin works by changing the growth conditions of your skin. It makes them more favorable to diverse bacterial populations instead of changing the number of bacteria that are already present.
The effect seemed to continue even after the participants stopped using the drug but the oil production became normal.
After a round of treatment, the microbial communities on the skin seem to shift to a diverse population. This population is a lot healthier and seems to persist for months even after the drug is stopped.
Understanding the mechanism of action of isotretinoin was just the beginning. The team is now set to work on a larger study with hopes to improve the treatment of acne.
Dr. McCoy concluded by saying that there might be a way to provide the human skin with some form of weed killer or a potential microbial fertilizer which could stimulate the growth of healthy microbes.
But who would benefit from such an effect?
Reducing the side effects associated with the use of isotretinoin would be of great benefit, especially for those who are using it currently.
For pregnant women suffering from acne, this could potentially prove to be a game changer.
Women normally tend to avoid acne treatments during pregnancy, mainly because there is no good therapy to use without compromising safety. They need options and the researchers are determined to find more.