Figure 1: Even Emma Stone from the movie Easy A gets acne! 1
Most people experience blemishes and acne at some point in their lives, even celebrities like Emma Stone. It is frustrating and can lead to self-conscious feelings. There is a treatment out there called 13-cis-retinoic acid (cRA), but is it worth the risks?
It’s a pill that you can take once a day for about 4-6 months that will really decrease acne, but it comes with risks. Its chemical structure looks like Vitamin A, but behaves slightly differently within our bodies.1 In our bodies, our cells constantly divide, this allows us to grow, and heal from wounds. CRA actually increases the rate at which our cells divide.2 This allows skin cells to be shed faster, and the buildup of oil in skin to decrease, both of which decreases acne. Sounds great right? Well cRA also comes with side effects such as extreme dryness.3 Dryness of skin and eyes can cause significant irritation, nose bleeds and even hair loss.3 It may also change your mood.3 Do you want to risk becoming bald and depressed? I sure don’t!
Although these are issues, they aren’t the biggest risk associated with cRA. CRA is classified as something called a teratogen.3 That means that it disrupts the development of an embryo during prenatal development.3 It can cause issues with the central nervous system, such as causing a baby to be born with its spinal cord on the outside in a condition called spinal bifida.4 In addition babies can be born with disfigured faces and ears, and even developmental disorders.5, 6 Another issue with cRA is that it may stay in the blood long after someone takes their last pill, and this can cause problems with women who want to get pregnant shortly after taking cRA.7 If anyone you know is thinking about taking this medication and wants to have babies soon, tell them to stay as far away from this medication as they can! As an alternative you can tell people that there are face washes for minor acne, and for more severe acne there are other options such as antibiotics.8
Everyone needs to make the decision for him or herself if the benefits outweigh the risks of any medication, including cRA. For me, I don’t think that cRA’s risks are worth the benefit of having clear skin, do you?
 Guerrero, A. Celebrities Are Just Like Us: They Get Acne Too. http://www.medulous.com/blog/celebrities-us-acne/ (accessed April 1, 2015)
 Accutane. Encyclopedia of Toxicology, 2nd ed.; Academic Press: MA, USA, 2005; pp 7-9.
 Layton, A. The use of isotretinoin in acne. Dermato-endocrinology [Online] 2009, 1(3), 162-9. http://library.mtroyal.ca:2107/pmc/articles/PMC2835909/pdf/de0103_0162.pdf (accessed March 14, 2015).
 Columbia University. http://www.columbia.edu/itc/hs/medical/humandev/2005/HD19/TeratogensSyllabus.pdf(accessed March 5, 2015).
 Sarici, D. Akin, M. A., Kurtoglu, S., Uzum, K., and Kiraz, A. Asymmetric crying face in a newborn with isotretinoin embryopathy. Pediatric Dermatology [Online], 2012 30(6), 289-290. http://library.mtroyal.ca:2104/doi/10.1111/j.1525-1470.2012.01743.x (accessed March 5, 2015).
Van Abel, K. M., Nelson, M. E., Collar, R. M. and Lesperance, M. M. Development of canal cholesteatoma in a patient with prenatal isotretinoin exposure. International Journal of Pediatric Otorhinolaryngology, [Online], 2010, 74(9), 1082-1084. http://library.mtroyal.ca:2139/science/article/pii/S0165587610002648 (accessed March 5, 2015)
 Health Tap. https://www.healthtap.com/topics/how-long-does-it-take-to-get-accutane-out-of-system-before-ttc)careful (Health Tap, 2014) (accessed March 5, 2015)
 Mayo Foundation for Medical Education and Research. http://www.mayoclinic.org/diseases-conditions/acne/basics/treatment/con-20020580(accessed March 5, 2015).