Roe V. Wade Reversal Has Patients On Accutane Worried

The US Supreme court’s decision to overturn Roe v. Wade keeps making waves, in unexpected ways. First, many were appalled by what they considered a restriction of women’s reproductive rights. Now past the initial shock, some are wondering about the decision's possible consequences on the access to birth control and acne treatment isotretinoin, known as Accutane in the US.

A brief on Accutane

Accutane, the commercial name for the medicine isotretinoin was released in 1982, over a decade after Roe v. Wade. It's an oral retinoid prescription treatment for treating severe, debilitating acne that had not reacted to previous medications for millions of patients. The prescription for Accutane comes with an important warning, among other side effects such as chapped lips and muscle soreness: taking medication while pregnant might result in a miscarriage or severe birth deformities. Thus, this drug classifies as teratogenic.

In fact, before prescribing isotretinoin to a patient, dermatologists subject the patient to a series of tests, including a blood pregnancy test, to rule out any gestation. The drug’s package also highlights the risks. A silhouette of a pregnant woman with a giant 'X' through the middle of the pillbox is a daily reminder of the significance of pregnancy prevention.
Moreover, as isotretinoin treatment usually lasts an extended period (three to nine months), practitioners require the patient to be on birth control to avoid getting pregnant while on Accutane.

Besides, it’s also recommended patients wait a few weeks after finishing their Accutane treatment before attempting to carry a child.

What the present situation could mean for Accutane users

Nonetheless, mishaps sometimes happen. Therefore, many users are concerned about a frightening potential reality: being pregnant while on Accutane and not having access to abortion care.

Following the recent Supreme Court ruling, Accutane users on the Reddit subreddit /r/Accutane have questioned doctors prescribing teratogenic black-box warning drugs in states where women aren't protected.

Furthermore, Redditors wonder if an abortion ban could lead to a restriction on isotretinoin prescription in the long run. Finally, people have feared having sex following the Roe v wade overturn.

While specific details are still unknown, one thing is sure: Accutane will be prescribed with greater caution as access to abortion continues to decline.
Abortion has always been an option if precautions not to get pregnant fail. However, some practitioners are now concerned about what would happen if forced to carry out a pregnancy.
Doctors report there is no safe level of Accutane exposure, and even brief doses might result in congenital abnormalities.

Is isotretinoin safe?

Yes, Accutane is generally safe; but it can be risky if the person taking it becomes pregnant or is pregnant. According to Refinery 29, Accutane is a Category X medicine (the highest risk rating) according to the FDA's 1979 Pregnancy-Risk Assessment because human and animal research has shown it to cause fetal defects during pregnancy.
That is to say, it has always been and will continue to be administered sparingly. Still, it's vital to recognize that acquiring an Accutane prescription is often a last-ditch effort to clear one's skin.

People who go on isotretinoin have exhausted other options without results.

People in states where abortion is entirely illegal are undoubtedly the most vulnerable if they get pregnant. Accutane may become too dangerous to dispense safely in places with abortion restrictions or trigger laws.

Alternatives to Accutane

There are various acne treatment options on the market: oral and topical solutions. These include Tetracyclines, zinc, Spironolactone, benzoyl peroxide, adapalene, etc...… Some of these can be bought without a prescription in many countries.

Alternative remedies, whether oral or topical, are dependent on the patient. For example, Spironolactone, a prescription medicine, is regularly administered because it helps with the hormonal component of acne. It is crucial to note, however, that Spironolactone also carries hazards.
Although less intense than Accutane, Adapalene is also unadvised for pregnancies.

Withal, the problem is that most people who would benefit from Accutane have already tried all those alternatives.

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