Benefits and risks of drug for acne

The impact of severe acne on self-esteem shouldn’t be underestimated, especially by GPs who tend to see it as a minor complaint.

The huge psychological effect was sadly highlighted last week by the inquest into the suicide last year of 18-year-old Melissa Martin-Hughes, who was suffering from acne and taking Roaccutane, which has been linked to depression.

Melissa Martin-Hughes, 18, was found hanged by a passer-by next to a children's playground in a park in Cheltenham, Gloucestershire

Melissa Martin-Hughes, 18,was found hangedby a passer-by next to a children's playground in a parkin Cheltenham, Gloucestershire

What exactly is Roaccutane

A drug used for severe cases of acne. It reduces sebum and acne-forming bacteria in the skin. It can be very useful in patients who have scarring, late onset acne and where other treatments have failed.

Treatment is often required for up to eight months and it must only be prescribed and monitored by a dermatologist. It is an effective but very toxic medication.

Severe acne can seriously affect the sufferer's self-esteem

Severe acne can seriously affect the sufferer's self-esteem

If severe acne can lead to depression, is it unwise to give a drug that may worsen psychological problems

It is difficult to separate what is caused by the condition and what is caused by the treatment.

No studies have proved a causal link between Roaccutane and depression, but clinicians are aware of an association.

Roaccutane is a chemical similar to Vitamin A, and it is not clear why this could cause depression. If any mood changes occur, it should be stopped or continued with psychiatric support.

Why is it prescribed if it can be so damaging

It is a very effective treatment but prescribing it is a balancing act for clinicians and patients. The benefits and the risks have to be carefully weighed up: for the majority of patients, the side effects are minimal and the improvement in their skin very significant.

Are other treatments effective

There are other safe, effective treatments, but even if one is to be effective, it can take months to work and people must be strict with their prescribed regime.

Oral antibiotics or, for girls, the contraceptive pill are widely used and work well. Topical benzoyl peroxide is also effective for mild to moderate acne. /Dr_Ellie