Brief Answer:
Isotretinoin is safe and effective for acne.

Detailed Answer:
Hello. Thank you for writing to us.

I have taken note of query and I have understood your concern about side effects of Isotretinoin, the main active ingredient in Tretiva.

Isotretinoin is an approved drug for moderately severe to severe grade of acne.

Your doctor has started you on a very low dose of Isotretinoin i.e 10 mg once every 3 nights.
The usually starting dose is either 10 mg Or 20 mg, once daily and later it can be increased to 20 mg twice daily.
However, the dosing schedule and doses can be made flexible according to the severity of acne and usually the treating doctor is best person to decide on dosing.

In females the most concerning issue about Isotretinoin is that it is teratogenic i.e it can adversely affect the fetus, therefore retinoids are either avoided in females of reproductive age group who cannot guarantee adequate contraception. It can be given only in females in whom adequate contraception is assured.
This restriction on pregnancy is till the patient is on Isotretinoin and for 1 month after discontinuing Isotretinoin.
Since you are getting married soon therefore you have to ensure that you don't get pregnant while you are on Isotretinoin and for 1 month after discontinuing it.

Apart from the adverse effect on pregnancy, Isotretinoin can be assumed to be fairly safe for treatment of acne.
Minor side effects like cheilitis, dry skin, increased hair shedding are the most common side effects of Isotretinoin. However, they are less common with low doses such as your doctor has planned and are reversible on discontinuation.

Other side effects like minor elevations of liver enzymes, elevations of serum triglycerides are less common with low doses, are reversible and usually don't warrant discontinuation of treatment. Nevertheless they should be monitored in patients on Isotretinoin treatment.

Isotretinoin is absolutely non-hormonal i.e it has no hormonal side effects and does'nt alter menstural cycles in anyway.

Finally, there have been few reports of suicides in patients on Isotretinoin but that is because the patient were already suicidal because of severe acne or other psychological problems.
On the contrary, Isotretinoin by improving acne improves quality of life in acne patients and is thus supposed to give a sense of well being and hope in patients depressed due to severe acne.

In my view Isotretinoin brings remarkable improvement in severe acne and is considered to bring about the most significant improvement in moderately severe and severe grade acne.
This is specially of benefit in acne patients who have had acne for years and in those whose acne is not responding as expected to traditional antiacne medications Or relapse quickly.

Regards

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Brief Answer:
Need more information about your concern regarding hair thinning

Detailed Answer:
Hi

Yes, Isotretinoin can be continued for 4 months or even longer depending on the severity of acne and response to treatment.
Nacfil is aimed at improving insulin sensitivity and acne resulting due to hormonal imbalance, particularly in patients with PCOS. It has no interaction with isotretinoin or its side effects.

Regarding hair thinning I would like to know more from you so that I am able to guide you better..

-Is hair thinning more from the center of scalp i.e front, mid and vertex?
-Do you notice that your scalp hair does'nt grow as long as they used to grow, few years back and are shed prematurely?
-Approximate number of hair that you shed per day? More than 50/ day, 50-100/ per day Or more than 100/ per day?
-Do you also suffer from dandruff?
-Do you have any history of thyroid? Or recent medical illness before the onset of hair fall?

Regards

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Brief Answer:
Topical Minoxidil and Oral Biotin Supplement

Detailed Answer:
Hi.

You seem to have Female pattern Androgenetic Alopecia.

It is characterized by hair thinning, increased hair shedding & decreased volume of hair mainly from the center of scalp i.e front, mid and vertex.

Course is gradually progressive over the years.

Minoxidil 2% solution, 1 ml, twice daily, at scalp skin & Oral Biotin supplement, once daily would help in preventing further hair loss.

Regards

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