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Investigation by Carolyn Skelton. [Part I. Part II.] RECENT DEVELOPMENTS IN SCIENCE and technology have opened up exciting new opportunities, solutions, and connections for many of us within and beyond New Zealand.  In this period of intense globalisation, the internet has enabled me to research my family history, much of it spanning older slower periods of globalisation, and to make new international connections. I have begun corresponding with distant relatives who I previously never knew existed.  As a result, of have learned about some of their trials and tribulations.  One such distant “cousin” had her life forever changed as a result of her son’s struggles with acne, and the drug that promised a magical cure for it. In trying to understand how such a commonplace medical problem could turn out to be so devastating, I have been motivated to do further investigations, internationally, and in New Zealand.  These investigations have led me to look at the impact of acne on young people, too often dismissed as fairly trivial part of growing up – something that people will grow out of.  In fact, the condition often needs appropriate care and careful consideration.  I have also learned about the side effects of a powerful but “controversial” drug, isotretinoin, on some young people’s lives: a prescription drug that can provide a magical cure for the majority, while, for a very small minority, it can have dangerous side effects. This is the first of a series of articles about my investigations. Later articles will look at aspects of this and other powerful prescription drugs, the role of the internet, Big pharma, the NZ context, and the potential impact of the Transpacific Partnership Agreement. Acne, isotretinoin, and the impacts on young people The first I heard of this isotretinoin, was from the blog of my UK “cousin” whose son Olly, was a talented and creative young man with enormous potential. His live changed after he took a course of RoAccutane, the brand name for Roche Pharmaceutical’s drug, isotretinoin. Following this his mental state changed, and the response of some health practitioners at the time was inadequate.

We just want to give you an idea of what he was like, cos he really was a wonderful son and a good friend to so many, and its such a tragedy that he died when only 32, partly, in our opinion, due to well documented, although rare, side effects from a medication called RoAccutane (Isotretinoin) when he was 21 to cure his acne, but it seemed to affect his mind really badly from the outset and continuing over 11 years causing chronic anxiety.  He and we felt that in the end, largely because doctors and psychiatrists did not understand this and so could not help him in time, he was in so much physical and mental pain that his life became unbearable and he felt he could not go on.
As a consequence they have linked up with parents of other young people who also suffered severe side effects of the drug.  Their campaigns have resulted in more media coverage in the UK, than we have had here in NZ. [caption id="attachment_3039" align="alignleft" width="300"]Dying for clear skin Jessie_1 Jessie: Screencap from Dying for a Clear Skin: BBC[/caption] Acne, while seemingly a trivial ailment, can have a significant impact on the lives of many young people.  In a society which over-emphasises youth and physical perfection, even fairly moderate acne can result in loss of confidence, depression, and bullying.  This drives many to look for a really good cure. Isotretinoin can do the job for severe acne, but it should be used as a medicine of last resort, by health professionals with a thorough understanding of the drug, its side effects, and ways to respond to them. Drugwatch.com explains some of the history of isotretinoin.  It was originally developed as a chemotherapy cancer treatment, but was found to also cure severe acne. [caption id="attachment_3041" align="alignleft" width="300"]Dying for clear skin Roche Screencap from Dying for a Clear Skin: BBC[/caption]  
Accutane (isotretinoin) is an acne medicine that reached the U.S. market during the early 1980s and quickly become a best-settling prescription drug. Since then, a number of studies have connected Accutane to numerous side effects ranging from birth defects to Crohn’s disease to suicide. Although the drug was hailed by dermatologists as a breakthrough treatment for patients with severe acne, Accutane’s dangerous side effects affected thousands of patients during the past 30 years.
Other companies now produce isotretinoin, and it continues to be a big earner for the companies.  They claim that there is no proven causal link between the drug and psychiatric problems or suicidal thoughts. The vast majority of people have taken the drug, without having any devastating consequences, and have been very grateful for its benefits. For a minority of users, the side effects could include, among other things, vision and hearing problems, joint pains, dry eyes and skin, diarrhoea, vomiting, liver damage, depression and suicide.  If taken when a mother is pregnant, it can cause birth defects in her child. [caption id="attachment_3040" align="alignleft" width="300"]Dying for clear skin Will Will: Screencap from Dying for a Clear Skin: BBC[/caption] A very good 2012 BBC TV documentary, Dying for a Clear Skin, explains how acne is experienced by many young people.  It shows the impact of RoAccutane on the life of Jessie and his family and friends.It also tells the uplifting story of Will whose acne was cured as the result of an expensive alternative treatment by a Harley street specialist. It begins by explaining that 85% of young people get “zits”, and asking some young people about their experiences with acne. To be continued. –]]>

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