Of the 85% of teenagers (between the ages of 12 and 24) that suffer from acne, 25% will have permanent scars ranging from severe to light. The American Dermatologist Association finds that:

• 20% of all adults have active acne
• 60 million Americans have active acne
• 20 million Americans have acne badly enough to cause scars.

Acne affects people regardless of age, gender or race. While thoroughly treatable, of those who suffer from acne:

• 11% will see a physician
• 20% will go to a skin care center
• 30% will use an over-the-counter medication from a drug store or pharmacy
• 40+% will do nothing

The concept of 40% of sufferers doing nothing is tragic. Since 1982, we have had access to a prescription drug that treats serious cases of cystic or nodular acne. That was the year isotretinoin, under the trade name Accutane, was approved by the FDA for the treatment of severe acne. Its exact mechanism is not known, but it is thought to limit the production of sebum. Most patients see significant improvement, or remission, after a 15-to-20-week course of treatment with isotretinoin.

The drug was controversial from the start, as it is known to cause teratogenic birth defects. All physicians and patients involved with this treatment must abide by a strict pregnancy risk-management program. Isotretinoin has some other serious side effects, too. Mild side effects involve skin dryness and eye dryness, rashes, headaches, hair thinning, and backaches. More serious side effects include inflammatory bowel disease, alopecia, catacracts, blood glucose problems, and more. Because of these side effects, it is only recommended to treat the most severe cases of disfiguring acne, and patients must pay close attention to side effects.

Availability of the drug has changed this year, resulting in some confusion in consumers. Earlier this year, in July 2009, Swiss drugmaker Roche announced that it was discontinuing its sales of Accutane and moving to delist with the FDA. This was not done for safety and efficacy reasons (although Roche has had to defend itself in many lawsuits), but rather because generics of Accutane (isotretinoin) have been available since 2002 and now dominate the market. Accutane itself had only held on to a 4-5% share of market, and it did not make business sense Roche to keep selling it.

Accutane is still available in many countries outside of the United States. Within the United States, its generic form, isotretinoin, is available, and this drug is also marketed as under several different names within the United States: Claravis, Amnesteem, Sotret are a few of the best-known.

Accutane being retired in the U.S. has caused a great deal of confusion among consumers. Posts on many popular acne-related message boards reveal people trying to compare side effects and benefits of several different brand names that are all essentially isotretinoin. To clarify: there is no difference between Accutane, Sotret, Claravis, or generic isotretinoin except for their makers and packaging.

If your doctor has prescribed a cream instead of a pill, topical isotretinoin is marketed under the trade name Isotrex.

If you are one of the millions suffering from acne, know that you do have options, and your condition can improve.

It’s a very dangerous drug—it causes birth defects, it causes psychosis, it causes IBD. When you’ve got a drug like this you shouldn’t mince words at all, which is at the heart of the case. No question that’s been our point, and in three cases, we’ve won $2.5 million, then just over $7 million, then now almost $11 million. That’s closing in on $20 million in three verdicts.

You can read more on these cases at Drug Injury Watch.

Accutane is the brand name for oral isotretinoin, a drug generally used for the treatment of severe acne. Claravis is a leading generic brand of the drug. In the eDrugSearch.com database, Accutane starts at a unit price of $1.18 in our search results, which is actually a lower price than for our Claravis search results.

In terms of efficacy, the drugs are basically identical, but also come with unavoidable — and sometimes severe — side effects. Unless your acne has failed to respond to other treatments (such as antibiotics), most doctors recommend exhausting your other options first.

The most dangerous potential side effect is for unborn children. To ensure that female patients don’t start on isotretinoin while pregnant (or while having the potential to become pregnant), a Web-based program called iPLEDGE was launched in 2006. Mandated by the FDA, the site requires dermatologists to register their patients before prescribing the drug, and pharmacists are required to check the site before dispensing.

Part of the purpose of the FDA program has been to discourage patients from buying isotretinoin online, because the FDA believes there is an increased chance of women ordering the drug without knowing the pregnancy risks. (As users of our site know, the online pharmacies within the eDrugSearch.com database all require a doctor’s prescription. Canadian pharmacies, however, are not part of the iPLEDGE system.)

So what’s the lesson in all this?

We can’t depend on drug marketers to tell us of their drugs’ risks. Unfortunately, too often we can’t depend on the FDA, either. So protect yourself with knowledge before filling a doctor’s prescription for Accutane or any other drug.

1. Accupril
2. Provigil
3. Viagra
4. Combivent
5. Acyclovir
6. Phentermine
7. Statins
8. Acne
9. Yasmin
10. Plavix
11. Lipitor
12. Crestor
13. Anxiety
14. Synthroid
15. Anaphylaxis
16. Valtrex
17. Topamax
18. Vytorin
19. Remeron
20. Xenical
21. Imitrex
22. Levaquin
23. Byetta
24. Celebrex
25. Strattera

As we state each month, the list isn’t a perfect reflection of the most popular drugs purchased online, largely because of Google. For a variety of reasons, eDrugSearch.com appears very high in the organic search results for some drugs, but not as high for others. This obviously skews our results.

With this caveat, however, we hope that over time our results will shed light on trends in online drug sales.

We’ll post our January 2008 results next month.

1. Accupril
2. Provigil
3. Viagra
4. Plavix
5. Yasmin
6. Lipitor
7. Acyclovir
8. Zyprexa
9. Vytorin
10. Acne
11. Strattera
12. Climara
13. Phentermine
14. Imitrex
15. Anxiety
16. Xenical
17. Antidepressants
18. Crestor
19. Abilify
20. Synthroid
21. Topamax
22. Amoxicillin
23. Zetia
24. Combivent
25. Valtrex

As we state each month, the list isn’t a perfect reflection of the most popular drugs purchased online, largely because of Google. For a variety of reasons, eDrugSearch.com appears very high in the organic search results for some drugs, but not as high for others. This obviously skews our results.

With this caveat, however, we hope that over time our results will shed light on trends in online drug sales.

We’ll post our December results next month.