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Thursday, January 15, 2009

Faceless Babies and Acne

Posted by on Thu, Jan 15, 2009 at 10:59 AM

First of all: people are starving and being tortured and killed for no reason the world over, so what I'm about to say does not much rate, but I'll just give it a go anyway.

So I go to the acne doctor this morning. I am 33 and got acne about two years ago. I did nothing about it for the longest time, because it's just acne, and who cares, and then I finally went to the dermatologist, who put me on antibiotics that I'm supposed to take for six months, and this was my six-week checkup. The acne is mostly gone but not all gone. The doc says: If you want it completely gone, the only thing that makes a permanent difference is Accutane. Accutane, evidently, is the wonder drug of the acne world. (Or maybe it isn't, but this is how it sounds when I'm sitting there.) She says it will actually change my glands, or somesuch, and that I have to take it for six months. She says it is essentially a huge blast of vitamin A.

The only twist is that in order to take Accutane, you have to join an FDA program called "I Pledge," which sounds creepily like an abstinence cult—and actually isn't all that far off from an abstinence cult. Before you can get the drug, you have to take not one but two pregnancy tests. The dosage is six months. Every month you have to take another pregnancy test. The reason is that Accutane causes severe birth defects, she says. The way she rests on the word "severe" makes me think it causes babies not to have faces, not just miss a finger or something. Then she tells me that in addition to the tests, you also have to prove that you are on not one but two forms of birth control. "We prefer a hormonal course," she says, meaning the pill, along with condoms. I am not accustomed to being told what other people prefer I do with my uterus quite so starkly. Evidently you sign something saying you're using the condoms and the doctor prescribes you the pills, too. Or you get an IUD implanted. I didn't get the sense that, say, pledging to use condoms and a diaphragm would be sufficient.

I have to admit that I was offended. On the other hand, I don't take babies without faces lightly. I couldn't help but wonder: Are there lots of drugs out there that have this kind of FDA pledge program for women attached to them? (The vitamin A doesn't touch sperm, the doc said, so men can do what they want with Accutane and sex.) Or is Accutane singled out because acne commonly appears in horny and irresponsible teenagers?

 

Comments (99) RSS

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1
I don't know what other drugs, if any, are controlled this way, but I do know that Accutane has been targeted with huge numbers of lawsuits by women who were warned about birth defects, but got pregnant anyway. I'm guessing that I Pledge is all about doctors and pharmaceutical companies covering their asses via FDA requirements.
Posted by keshmeshi on January 15, 2009 at 11:05 AM
2
If you participate in a research study for any type of an investigational drug, you often have to sign a consent stating that you'll use two forms of birth control.

Posted by Thalidomide babies, testify. on January 15, 2009 at 11:05 AM
3
I had to take the pledge. I wasn't too offended because I was 16 at the time, and all 16 year olds are retarded. Imagine an acne ridden, retarded 16 year old with a faceless baby.

Anyway, you are a grown woman, so your offense makes perfect sense. BUT GOD WHAT ABOUT THAT FUCKED UP BABY! Take the pledge, Jen Graves. Your skin will thank you (your diseased half-dead accidental baby will NOT).
Posted by meags on January 15, 2009 at 11:06 AM
4
Watch out, because that shit will dry out and irritate your skin. Your lips will pretty much slough off. My friend was on it for a long time, and it did clear up his skin for a few years, but his skin was always dry and irritated and it made his back hurt.
Posted by Carollani on January 15, 2009 at 11:07 AM
5
oh, also, they put an illustration of the faceless baby on every pack of the 'tane. there's also an illustration of a pregnant lady with a big red x over her belly, just to remind you not to fuck up.
Posted by meags on January 15, 2009 at 11:07 AM
6
I take methotrexate for arthritis and my doctor repeats and has me swear up and down every time I visit him that I am using super birth control because it causes defects and miscarriages. This one can also cause birth defects through guys as well so if they want to get their gal pregnant, they have to go off the med for at least three months prior (same with the ladies). I didn't have to sign anything or swear on a bible but maybe that's because I live in Canada. Perhaps the US is different?
Posted by printer on January 15, 2009 at 11:07 AM
7
who's gonna fuck you with all those zits anyway?
Posted by doogie howser on January 15, 2009 at 11:08 AM
8
What if you were gay? I sure hope they're not trying to force lesbians onto birth control. Or a nun! What if you were an acne-ridden nun?
Posted by leek on January 15, 2009 at 11:10 AM
9
Yes, nothing is more offensive than being told you have to be responsible for your behavior because it could negatively effect others. Your right to behave as selfishly as possible is the only right that matters anymore.
Posted by Kerry on January 15, 2009 at 11:12 AM
10
You also can't drink on Accutane.
Posted by skreddie on January 15, 2009 at 11:12 AM
11
@6: Yeah, perhaps.
Posted by TVDinner on January 15, 2009 at 11:14 AM
12
Jesus, the cure sounds a heck of a lot worse than the disease.
Posted by dwight moody on January 15, 2009 at 11:16 AM
13
I was on Accutane in high school, and they don't mess around with it. Each pill was trapped behind a plastic bubble (like Dentyne) and to get it out you had to push it through a picture of a pregnant woman circled and crossed out like a no-smoking sign.

Also, it makes you suicidally depressed, so be careful!
Posted by Drew on January 15, 2009 at 11:18 AM
14
I was on drugs that would cause my child to have yellow teeth. That is permanently yellow teeth. According to my doctor the teeth would still be functional just yellow. My doctor was seriously concerned for this potential yellow toothed kid and we had lots of fights about me going on the pill. I didn't want to go on the pill because I was too sick to have sex anyway. If for some reason I decided to have sex I would use a condom. If the condom broke I would use plan B. If Plan B failed I would use abortion. That's 3 forms of birth control, I pointed out, 4 if you count illness induced abstinence. But eventually I just had to lie to him. It was an expensive lie.

I don't have any kids, yellow toothed or otherwise.
Posted by Me too on January 15, 2009 at 11:21 AM
15
Accutane has insane side effects even if you don't get pregnant. Unless you've tried everything else including dietary changes, I'd stay away...

http://en.wikipedia.org/wiki/Isotretinoi…
Posted by Kem on January 15, 2009 at 11:21 AM
16
I never had to take this alleged Pledge while I was on Accutane (I think I was 14 when I started, 16 when I ended). Maybe I was too young, maybe they hadn't made it up yet. On the other hand, Accutane is pretty much a selfish drug...you're doing it for how you LOOK, after all.

I will say, your skin gets paper-thin and one time I yawned and the right side of my mouth cracked open about a half-centimeter. I still have a dark patch where it was split for a couple months. Keep a good cocoa-butter/Vitamin-E lotion on hand for your face.

It causes depression in some teens, but I suspect this has to do with them going from pizza-faced to paper-faced within a month.
Posted by Kat on January 15, 2009 at 11:21 AM
17
I sincerely don't understand why you should be offended at this. It sort of seems like the people who get angry when they're carded buying alcohol--"Are you calling me a liar?" Your doctor does not have the discretion to decide that you're a responsible person who can be trusted to take precautions, and there's no apparent reason why he SHOULD be given that discretion. Besides, responsible people can make mistakes, too. Nobody seems to be advocating for the right to get pregnant while using this drug, so why is it a problem for them to say that you can't, and to ask for your guarantee that you'll take reasonable measures to prevent it?
Posted by Propaniac on January 15, 2009 at 11:21 AM
18
@14: The pill is important with various drugs, not just for prevention. Spironolactone usually comes with a side-order of ortho-tricyclen, to keep hormones balanced.
Posted by Kat on January 15, 2009 at 11:22 AM
19
I took Accutane when I was 20 and it made my terrible acne go away and stay away. The dry skin sucks, but Cetaphil moisturizer works fine (just carry it around with you) -- use Aquaphor for your lips. The depression thing affects teenagers, but not adults as far as I know. It worked when nothing else did. I'd recommend it, personally.
Posted by seattleeco on January 15, 2009 at 11:25 AM
20
Reading up on Thalidomide in Europe in the 50s might help you understand.
Posted by Fnarf on January 15, 2009 at 11:25 AM
21
@10 Oh yeah...I forgot. Not only can you NOT DRINK on Accutane, you can't drink for 6 months after you get off the pill. It's no joke.

One of the ways they found if a specific group of proto-humans ate meat was that they found bone growths on a fossil that suggested the proto-human had eaten the entire liver of a large animal, or perhaps lived off liver. Your body can't deal with very much Vitamin A, much less so when your liver is already stressed with booze.
Posted by Kat on January 15, 2009 at 11:25 AM
22
Accutane will dry out you and your fetus more than you can imagine. Don't be offended by The Pledge.
Posted by Vitamin A on January 15, 2009 at 11:26 AM
23
Shouldn't the acne count as one of the forms of birth control?
Posted by elenchos on January 15, 2009 at 11:28 AM
24
actually, the emphasis on "hormonal birth control" makes me think that it's not just the "Birth Control" aspect that they are worried about.

unstable and unpredictable hormonal cycles ARE a problem for drugs interactivity in women. it's one of the (and pretty much the ONLY) good reasons for the disparity in medical testing on women vs men. women have a MUCH more volitle hormonal cycle (that varies EXTREMELY widely from person to person)--and the chemicals we have messing with our systems mess up drug effects. for a drug that, presumably, acts on the hormones--I'd say the precautions are necessary for Accutane to work predictably.

for men--the hormonal cycle is less volitile, and much more standardized between individual men on a general basis. they don't need to regulate and norm out thier cycles in order to get standard results.
Posted by chibi-evil on January 15, 2009 at 11:29 AM
25
I know two people who went on Accutane and afterward had to be treated for depression. The FDA jury is still out, but that stuff is scary.


They both did have clearer skin afterward though
Posted by Michelle on January 15, 2009 at 11:30 AM
26
Hell, if I couldn't drink or smoke, I think I'd be suicidally depressed too.
Posted by Fifty-Two-Eighty on January 15, 2009 at 11:31 AM
27
I'm pretty sure my older brother's best friend committed suicide after having been on Accutane. There is a major cover-up by industry lobbyists about the effects of Accutane, but I believe someone else in this thread also mentioned the depression effects. Just be careful.

I actually also concur with @9, because I think it's somewhat selfish to declare "How dare you say I can't have a retarded baby?!?"

I mean, this isn't just a genetic-mutation baby because you boinked someone. You're being specifically notified that your baby will come out like a mutant from Beyond Thunderdome and you're getting offended? I mean, aren't Stranger writers supposed to be all pro-science and appreciative and stuff?
Posted by Sam on January 15, 2009 at 11:35 AM
28
Just my two cents: I had a good friend who used Accutane. I wouldn't say it made him depressed, but it did give him drastic mood swings and fits of rage. He was a pretty soft-spoken guy, but I saw him stop his car in the middle of traffic and threaten to beat up a 12-year old kid for crossing the street too slow. Scary.

It did clean up his zits, though!

BTW, the liver of the polar bear is toxic to humans, specifically because of a Vitamin A overdose. Or so says Isaac Asimov.

I'm also confused as to why you're offended. It's a potentially dangerous drug with severe side effects. Why shouldn't health care providers take some reasonable precautions to make sure you use it responsibly?
Posted by anon on January 15, 2009 at 11:48 AM
29
Accutane DOES affect sperm and boys have to pledge to not make babies too -- we're just not tested for pregnancy or told to get vascetomies every doctor visit.

I've never been depressed while on it and my doctor told me it's OK to drink as long as my blood tests don't show signs of liver damage.

That is all.
Posted by teddy b on January 15, 2009 at 11:51 AM
30
The medication for pin worms is one that doctors stress you NOT be pregnant and take precautions to NOT become so. I don't remember any pledge per se, but things could have changed in the last few years.

Another interesting side effect of Accutane is that it causes many people's hair to become curly. Weird.
Posted by carol on January 15, 2009 at 11:55 AM
31
Would universal health coverage cover acne medicine?
Posted by And my boob job? on January 15, 2009 at 11:56 AM
32
Thalidomide is used for cancer treatment now. If you need to take it (and you're female), you have to sign something saying you won't get pregnant.
Posted by judith on January 15, 2009 at 11:57 AM
33
@28: When my roommate told me about the pledge, I was momentarily offended as well, but I really think it has to do with the fact that its called The Pledge. Most government-sponsored honor codes are stupid or destructive (see: Loyalty Oath).
Posted by Kat on January 15, 2009 at 11:58 AM
34
It's very well and good that you (claim to) have the brains not to get pregnant while using a drug that can cause "severe, life-threatening birth defects if the mother takes the medication during pregnancy...even one dose of Accutane can cause major birth defects of the baby's ears, eyes, face, skull, heart, and brain."

You can also use a computer, have critical thinking skills, and post blog items to the Web.

Many, many people out there lack these brains, and the same people risk being unaware they are pregnant (or have wacky ideas how not to get pregnant), thus bringing to full term a human being who will suffer greatly and likely die shortly after birth (hopefully).

Doctors cannot tell who has brains and who doesn't, so you get the spiel just like everyone else to minimize the likelihood of something tragic from happening. Don't take it so personally. It's not about you.
Posted by Simac on January 15, 2009 at 11:59 AM
35
I was on accutane for about 8 months and have no regrets at all. The birth control thing was a pain in the ass, admittedly, and the dry skin and lips were uncomfortable, but the results were so amazing (and I'd been struggling with severe acne for the year before) that I would do it again. Every month you see your doctor, do a pregnancy test, get another prescription, and then answer some questions about sex and pregnancy that are straight out of 7th grade health class (can you get pregnant having sex in a swimming pool? can you get pregnant if it's your first time?). You can drink while on accutane, and it has been known to cause depression in a small number of people, most of this is anecdotal evidence--I didn't feel depression, mood swings, or anything out of the ordinary except so so happy that my skin was clear. I did use two moisturizers on my face (try Moor Balm, expensive but totally worth it)and kept aquaphor around at all times--which my husband hated as my lips were always greasy. You do have to be organized about it as once you see your doctor and he/she enters the information they're required to on the ipledge site you have a week to do so yourself and fill the prescription.

Overall, it's a year later and my skin is still great. I would do it again if my skin got worse and if your doctor recommends it to you I would do it.

The pregnancy thing is a big deal, though. 100% incidence of SEVERE malformations among children born to mothers on accutane.
Posted by LS on January 15, 2009 at 12:03 PM
36
I'm with @28, why are you offended at being fully informed of the risks of this otherwise very useful drug? If you had cancer and were pregnant, your physician would counsel you to get an abortion or wait until after delivery for radiation, and most chemo, because both are deleterious to the developing fetus. He or she can't make that decison, you have to. Do you risk dying yourself and try to carry the baby to term, or abort now and increase your chances of survival? It is a tough call, but you have to be informed.

The pledge is intended to make it absolutely clear that you understand the risks of taking the drug and getting pregnant. The reason that they are so strict about compliance with women who *can* or *may* become pregnant, whether they intend to or not is that physicians have had to pay out massive settlements to women who were informed of the birth defect risk but became pregnant anyway and sued on the basis of not fully understanding the warning. Acutane was known to cause birth defects when it was released and the drug always carried a warning not to become pregnant but many people just don't believe what they are told until the worst comes to pass.

There are amny drugs which are known to cause birth defects but which also have great benefit to society. They also have warnings. A useful drug should not be withheld from society at large because it poses a risk to a discreet population, such as gravid or potentially gravid women.
Posted by inkweary on January 15, 2009 at 12:10 PM
37
24 - The emphasis on hormonal birth control is probably because it's the most effective form, aside from sterilization. And most doctors won't perform a sterilization on someone your age with no children, because women can't be sure that they don't want children until they've already had them or are past the childbearing age.
Aside from the how not to get pregnant for idiots warnings, this stuff sounds scary. I would run away.
Posted by Jen on January 15, 2009 at 12:10 PM
38
My father died of Multiple Myeloma. One of the treatment options was Thalidomide. He was 70 when he died, my mother was 68 - long past menopause. They had to sign something and promise that they would use birth control if he took the drug... I don't know how many simultaneous methods, but the fact that my mother was 68 was not sufficient. The doctor/pharmacist/whoever was pretty serious about it.
Posted by Sarah on January 15, 2009 at 12:13 PM
39
Accutane is pretty good but it does have the side effects noted.

Including drying out.

Anyone on Accutane really really needs to use two forms of birth control. Including men (who should at least provide one of the two forms).
Posted by Will in Seattle on January 15, 2009 at 12:17 PM
40
@10 - no, no problem drinking, and I didn't notice depression, but then back then I ran marathons and the endorphins from a 10-20 mile run every day may have made that not noticeable.
Posted by Will in Seattle on January 15, 2009 at 12:18 PM
41
Wow.

1) If, as some posters have suggested, the hormonal birth control is important for hormone issues connected to accutane and not just for birth control, then the doctor should have explained that. Since it wasn't mentioned I'm assuming here that that was not the reason.

2) Hormonal birth control has side effects. They're usually not that bad and lots of women choose to take it, but there ARE side effects and so it should be your choice. The side effects range from weight gain, vaginal irritation and pain during sex, to increased chance of death from blood clots. I take the pill myself, but I researched all these risks first and decided to make that choice. I wouldn't take kindly to someone telling me I HAD to be on it for a non-medical reason (and it is non-medical because you could always use other forms of birth control).

3) The doctor definitely should emphasize how bad the birth defects are and how important it is to make sure you don't get pregnant while on accutane. But this pledge stuff IS offensive. They can tell you they prefer for you to use two forms of birth control because its the smart thing to do, but it still should be your choice. If you mess up and get pregnant, then luckily its your legal right to abort the deformed fetus.

4) I'll give them a little bit of a pass on the grounds that they are probably trying to avoid a costly lawsuit, but I think you should have to sign a form only saying you're aware of the birth defect issue and have been advised that you should be on birth control. That's enough to cover their asses. This pledge stuff is creepy and offensive.

5) I guess you could lie about taking the pill but that would be expensive. Will they actually check if you filled the prescription? Will they check your hormone levels later??? So creepy.

6) I do think the pregnancy tests are a good idea though. No side effects there. But do they just tell you to do them at home, or do you have to come in to the office and waste a lot of time? if its home pregnancy tests, hopefully you're aware that you can get a pack of them online for much cheaper than getting one at a time at the supermarket.

(My boyfriend was on accutane years ago and now has back problems. It seems there's some anecdotal evidence about them being related but no real proof.)
More...
Posted by Handle on January 15, 2009 at 12:21 PM
42
Dry skin? Birth defects?
Sounds a bit like Harlequin Syndrome to me.
Although, apparently Harlequin Syndrome can be treated with Accutane. So who knows.
Posted by Look it Up on January 15, 2009 at 12:24 PM
43
Recently, plaintiffs were awarded multi-million dollar settlements from a lawsuit against Roche (Accutane's pharmaceutical company) for not disclosing research that proved Accutane can cause Crohn's Disease.
http://www.schmidtandclark.com/Accutane/
Posted by Weasie on January 15, 2009 at 12:25 PM
44
Women taking Acutane who mess up, get pregnant, and have faceless babies will sue the doctor/pharmacist/drug company. A couple of those cases and the product is taken off the market. Thus, the pledge.
Posted by Spokalou on January 15, 2009 at 12:28 PM
45
I just looked up iPledge on wikipedia, and they also have some good criticisms about doctor patient confidentiality, rights to privacy, etc.
Posted by Handle on January 15, 2009 at 12:29 PM
46
There have been several attempts to get Accutane pulled from the market because of the potential for birth defects. I'm somewhat surprised it's still available.
Posted by Parris on January 15, 2009 at 12:30 PM
47
Considering that they make me show ID and enter it into a computer to buy Sudafed, this level of precaution for something that will cause MAJOR problems isn't all that unreasonable.

And really, you know now that you'd get an abortion. But even when it's the right decision to make at the time, it can be hard to do when faced with it. And sometimes people have an entire change of values when pregnant. So it's not something to mess with.
Posted by amy! on January 15, 2009 at 12:38 PM
48
I was on Accutane for about two years in college and was seriously depressed the whole time. I ended up on anti-depressants as well. I can vouch for the noticeable, permanent skin and mucous membrane dryness afterward. It's been 10 years since I stopped taking Accutane and I still have very little sense of smell left.

The cystic acne, however, did eventually clear up during those two years.

If you can at all avoid it, I'd suggest sticking to the antibiotics and benzoyl peroxide lotions. In the few recurrances of acne I've had, I've found that the "Proactiv Solution" products work very well, though they're a bit pricey. They'll try to get you to sign up to have them delivered on a subscription, but be sure to call and cancel or at least reduce the rate of shipment if you're still using it.
Posted by Chris on January 15, 2009 at 12:42 PM
49
@8 Lesbians don't get pregnant? I'll have to tell all the lesbian moms I know that they have to give up their kids.
Posted by inkweary on January 15, 2009 at 12:44 PM
50
I've just started Soriatane for psoriasis, which is related to Accutane. They have the same laundry list of precautions and conditions. As a male, I was not required to sign any pledge (perhaps also because it's not the same exact drug), but I was told not to let the medicine anywhere near a child, a woman who is pregnant, or a woman who thinks at some point in the next few years she might possibly have the chance of getting pregnant. Apparently this is nasty stuff. The warnings that came with it also said not to give blood for something like 3 years after you *stop* treatment. I don't find all these rules and regulations that unreasonable--obviously they're not doing it to step on your rights, but to prevent birth defects. They're so worried that they won't even let you donate blood, on the off chance that there is enough in your system to damage some *other* mom or potential mom.

Having said all this, now I'm wondering if my face will fall off and if this was a good idea...
Posted by Jason on January 15, 2009 at 12:46 PM
51
Actually it is all a coverup. Heroes is a show based on reality and the reason that these people had these powers is because of the link that their mothers got pregnant while on Accutane.

(i'm lying - for anyone who couldn't tell already. Don't sue me if you have a faceless baby with no super powers please).
Posted by subwlf on January 15, 2009 at 12:57 PM
52
Guess why they do that? Because no matter how many warnings they give you or documents they force you to sign, if they didn't do it there were but a small but significant minority that would get pregnant, have a deformed baby and sue the doctor and the company that makes the drug. And given our legal system, even if they didn't win (they very well might), it would cost the company a small fortune to fight in court.
Posted by bob on January 15, 2009 at 12:59 PM
53
Seconding the commenter above who recommended reading the Wikipedia article if you really want to understand what this is about: http://en.wikipedia.org/wiki/IPLEDGE.

Requiring you and your doctor to ensure you're on birth control is one thing. Forcing you to give your entire sexual history (including STDs) to some stranger via a not-secure-enough Web site is another. And really, do you want to wait for the government to rubber stamp every refill? This is so much more draconian than procedures for other teratogenic drugs, or even for addictive drugs like Ritalin and strong opiates.
Posted by Rhiannon on January 15, 2009 at 1:07 PM
54
4) I'll give them a little bit of a pass on the grounds that they are probably trying to avoid a costly lawsuit, but I think you should have to sign a form only saying you're aware of the birth defect issue and have been advised that you should be on birth control. That's enough to cover their asses. This pledge stuff is creepy and offensive.


You thought wrong. I'm certain that a teenager who took the drug and got pregnant could sue on the grounds that the doctor and pharmaceutical company are obligated to demonstrate to her how not to get pregnant. The information they give to patients makes it clear that the FDA knows that people are fucking idiots. Among the questions I had to answer to prove I know how reproduction works:
Can someone get pregnant from having sex in a pool?
Does hormonal birth control have to be taken every day?
Can a woman get pregnant from having sex during her period?

A smart lawyer could absolutely sue the shit out of a doctor who failed to instruct and monitor his/her borderline retarded patients.
Posted by keshmeshi on January 15, 2009 at 1:10 PM
55
@53,

And really, do you want to wait for the government to rubber stamp every refill?


There's no waiting whatsoever.
Posted by keshmeshi on January 15, 2009 at 1:12 PM
56
count me in on being severely offended by "the pledge" and all it covers. I think it is sexist and a violation of civil rights, how do they get away with it?

Need to prove non-pregnancy prior to [any] prescription? FINE! Need it be a pledge? Just pee on the stick, sign a waiver and move on!

pledging to get not pregnant, pledging to take hormonal birth control, only asking women to make "a pledge" a promise -it's fucking mind baffling...

This is the 21st century, this is all we got? This is the first world we live in..
Posted by grumble on January 15, 2009 at 1:16 PM
57
There are newer laser therapies that apparently can help with acute acne.

http://www.acne-resource.org/understandi…

Results are supposed to be comparable or better than other treatments, including Accutane. Not only do you get to avoid the nasty known side effects of Accutane, but you get a freakin' laser! (You should avoid extended expose to the sun, but that's easy in Seattle.)
Posted by bhigh on January 15, 2009 at 1:23 PM
58
I still think signing a bunch of forms, watching a video about birth defects and answering questions to prove you watched it, that kind of thing should be sufficient. Having your medical history entered in a federal database is NOT necessary.
Posted by Handle on January 15, 2009 at 1:26 PM
59
@54 -- instructing is fine. Give them some literature, make them answer a multiple choice questionaire. In fact, with the state of sex ed in this country the kids might learn something new.

That is completely different than (a) forcing them to take hormonal birth control, (b) forcing them to submit personal medical information to a government website that may not be secure.
Posted by Handle on January 15, 2009 at 1:28 PM
60
Two birds, one stone: the birth control pill, Yaz, is also very effective at eliminating acne. It worked wonders for me!
Posted by SRJ on January 15, 2009 at 1:29 PM
61
oh suck it, inkweary. it should be clear that most lesbians (those who sleep solely with women, at least) get pregnant intentionally.
Posted by leek on January 15, 2009 at 1:30 PM
62
Why can't you use a topical antibotic/benzoyl peroxide combo? I'm in my 30s and I use Benzoclin everyday, which keeps my acne almost completely in check and, more importantly, doesn't FUCK UP MY SYSTEM. I took all those antibiotics for years and my stomach/immune system seemed to take years to recover.
Posted by jem on January 15, 2009 at 1:35 PM
63
Jen: Don't take the drug. It sounds like it will be hell on your body. What if it does permanent damage?

I had a bout with acne myself and I have found Clinique's Acne Solutions bar soap to be an over-the-counter godsend.

http://www.clinique.com/templates/produc…
Posted by Emily on January 15, 2009 at 1:50 PM
64
@ 62

Because some acne is worse than others and that stuff doesn't work.

Accutane worked wonders for me when nothing else did the trick. I'm talking like 10 years of "solutions".

No depression. And I drank while taking it.

Plenty of dry skin though while on the stuff though.
Posted by mbop on January 15, 2009 at 2:02 PM
65
how do they get away with it?


For one thing, it's not something that anyone has to do. Don't like it? Don't take the medication.
Posted by keshmeshi on January 15, 2009 at 2:06 PM
66
My grandmother took Thalidomide in the years leading up to my mother's birth; she had one horribly deformed baby that died and then my mom. Although physically my mother not have any obvious birth defects, around the age of 30 her body basically turned on her - her immune system went haywire and basically stopped functioning, she had osteoporosis and multiple surgeries to correct broken and fractured bones, degeneration of the discs in her spine, and all kinds of uterine problems like endometriosis. She spent most of the last half of her life in and out of hospitals and medical treatment and died at the age of 51. So, don't be offended. I suspect they made up this pledge for good reason.
Posted by a slog reader on January 15, 2009 at 2:14 PM
67
I hear you, sister. I was on the antibiotics for years. When I went off them, the acne came roaring back. I didn't want to try Accutane. The only thing that's worked for me was checking "The Acne Prescription" out of the Seattle Public Library and following it's recommendations to the letter. Worked for me. Also, it is free.
Posted by Eliza on January 15, 2009 at 2:17 PM
68
@61 and what if they are raped? Or just don't take the warning seriously?

The reason for the elaborate prescribing guidelines is that prior to the pledge there were many women who ignored all of the counseling and became pregnat while on the drug. Then blamed the doctors and the drug company.
Posted by inkweary on January 15, 2009 at 2:19 PM
69
@41 - Not to mention depression. I've done 3 different formulations, including a mini-pill, and I was clinically depressed each time. Now, I am a recurrent depressive, so occasional depressive episodes are things I deal with anyway, but going on antidepressants just so I could take birth control pills seemed stupid.

ESPECIALLY since if you weigh over 200lbs you are twice as lucky to have an "accident" on the pill. LOVE how a pill that makes you gain weight becomes less effective when you gain weight. :(

Jen, did they point out that antibiotics can make birth control pills not work?
Posted by living400lbs on January 15, 2009 at 2:40 PM
70
Half of my graduating class (2008) did Accutane at one point during high school, including my boyfriend. It makes your skin kind of gross and peel-y. If kids with bad acne started re-applying Chapstick constantly, you asked how many months into the treatment they were. One girl showed me her 'Accutane manual,' a huge binder detailing all the horrible things that can happen to a baby.
Posted by yourleastfavorite on January 15, 2009 at 2:49 PM
71
Maybe we need to direct our anger towards people like this.
http://www.cbc.ca/health/story/2004/02/2…
Posted by Jen on January 15, 2009 at 3:00 PM
72
I was prescribed it in the UK about 10 years ago. The dermatologist asked about pregnancy tests and contraception but when I told them I was a lesbian, they were satisfied with that - no need to take the pill or have any pregnancy tests. It sorted my acne out but yes, did dry my skin out a lot and leave it very thin. No after effects now except that my skin is more sensitive to the sun.
Posted by britgirl on January 15, 2009 at 3:29 PM
73
WHO CARES
Posted by about jen's acne on January 15, 2009 at 3:34 PM
74
You know, I thought about adding "as long as they aren't raped" but I figured that no one would seriously keep pursuing my statement to ensure that I added every possible disclaimer. Whoops.
Posted by leek on January 15, 2009 at 3:47 PM
75
I work in the pharmaceutical research industry. Yes, there are a number of drugs that have you sign a "no baby" pledge. Retin-A can make you have a baby with no HEAD, let alone no face.

If you're that concerned, try something less threatening first like Phisoderm washes followed by Oxy 10, and if that doesn't work move to Cleocin-T before Retin-A.
Posted by Research on January 15, 2009 at 4:08 PM
76
Did she tell you that accutane makes you loose your mind as well?
Just in case she didn't: ACCUTANE MAKES YOU LOOSE YOUR FUCKING MIND.
Posted by olive on January 15, 2009 at 4:12 PM
77
When will the ugly learn that God intends for them to be ugly. Trying to undue his will with tricksy drugs will only cause him to smite you with an even uglier baby.
Posted by You_Gotta_Be_Kidding_Me on January 15, 2009 at 4:20 PM
78
Try Prosacea. It's for rosacea, but I have a zitty form of rosacea, and can't go a day without it or I get a major outbreak. The downside is it contains sulfur, so your face and pillow start smelling like sulfur. But at least it doesn't make you kill yourself or have faceless babies.
Posted by whome? on January 16, 2009 at 3:21 AM
79
I loved Accutane. I didn't have any side effects except for dry lips (chapstick etc. works fine to combat that), it cleared my skin like a charm and my skin is still pretty good, 6+ years out after my year on the drug in college.

I am a lesbian, and yes, even I had to do pregnancy tests monthly. It wasn't a big deal. Any depression I had lifted once I had clear skin. I even drank alcohol while I was on Accutane and nothing weird happened.

Finally, I work in clinical research, and as far as side effects go this drug isn't too terrible in comparison to many other drugs I see.

All in all I think it's an effective drug and I recommend it. Just have them put you on a low dosage.
Posted by k. on January 16, 2009 at 9:08 AM
80
I know this is unsolicited medical advice from a non-medical person, but I had something similar where I never had skin problems in high school but started breaking out really bad in my late twenties and thirties. I met someone who had a soy sensitivity and who used to have similar skin problems until she quit soy - since I was regularly eating energy bars w/ soy protein isolates and soy milk, tofu, etc. I decided to go off soy for awhile and see what happened. And my skin got a lot better! It's not perfect, and I don't totally avoid everything with soy, but it's so much better.

I don't know what you eat, but if you are eating a lot of stuff with soy I would recommend trying a dietary change first before Accutane. Takes about a month to see if it makes a difference. I'm guessing the soy was messing with my hormones, which apparently can get really out of whack in your thirties.
Posted by asteria on January 16, 2009 at 10:14 AM
81
I don't think it's *wrong* to make patients sign pledges and so forth in order to gain access to the drug; the drug companies and doctors are just covering their asses. However, it does make the drug sound pretty damn scary. I was offered the accutane regimen by my dermatologist for bad acne in my early 30's and I ended up not doing it. Any drug that does this much crazy stuff to your body is just not worth it. I just stuck with the antibiotics and they cleared my skin up enough that it didn't look awful anymore, even if it wasn't perfect. Eventually my acne was cured - by a (planned) pregnancy. Apparently massive doses of preggo hormones will do the trick for some women. I, uh, don't recommend this course of treatment, however, unless you're interested in having a dependent. ;)
Posted by Jenbeee on January 17, 2009 at 8:34 PM
82
79
"I am a lesbian, and yes, even I had to do pregnancy tests monthly. "

What!
Why?!
Since you ARE a lesbian and therefore a non-reproductive being why did you have to test for (impossible) pregnancy? Doesn't the medical profession realize that Mother Nature doesn't make mistakes?
Posted by - I'm so confused... on January 18, 2009 at 5:07 AM
83
@71
Whom are we angry at; the woman or her doctor?
Posted by I need more info before I get angry on January 18, 2009 at 5:10 AM
84
49

WHAT?!!

see #82 above.
Posted by ... I fear my head will explode on January 18, 2009 at 5:15 AM
85
@71 - "The prescription itself did have an information package, but I didn't look at it." *sigh*
Posted by van on January 18, 2009 at 7:21 AM
86
Here's the easy solution to your dilemma, Jen: post a nice, clear picture of your acne-ridden face, and we, the readers of Slog, will vote on whether or not it's bad enough to justify using Accutane! Problem solved!
Posted by anon on January 18, 2009 at 7:44 AM
87
Jen, I agree you should be annoyed.
Having seen your face it would be a blessing if your offspring had zero chance at a dip from that gene pool.
Posted by eeeeuwwww! on January 18, 2009 at 8:50 AM
88
Jen asked if there are other drugs that require such a pledge. Yes, I was on a drug named Cytotec [spelling?] about 10 years ago and it, too, required a pledge not to get pregnant. But all I had to do is sign a form swearing I wouldn't try to get pregnant and, if I did, I wouldn't sue the manufacturer for anything that happened. And the bottle had about 13 stickers on it saying not to get pregnant, don't take it if you are pregnant or planning to get pregnant or nursing, etc. all over it.

I don't know if it is still on the market - it had awful, awful side effects - but if it is, I'm sure they've tightened up the no-pregnancy thing.

FYI, Cytotec is an arthritis drug [I have it pretty bad] and a relative of RU-486. It causes birth defects and miscarriages. RU-486 was originally designed to be an arthritis medication, until they knew the side effects [miscarriage]. Cytotec is not only less effective than RU-486 as an arthritis medication, it also has worse side effects. But the American Taliban couldn't allow an 'abortion drug' in this country, now could they?
Posted by schweighsr on January 18, 2009 at 9:06 AM
89
@85

Thanks.
stupid bitch...
Posted by now I'm really angry! on January 18, 2009 at 11:58 AM
90
Accutane scares the heck out of me. I wouldn't let myself be exposed to it let alone some poor little baby. I hate to give advice on this sort of stuff but you did ask....Being a fellow 30 something acne sufferer(it really sucks) I would recommend checking out the homeopathic cures at Whole Foods. I used that and it really helps! Plus they are only like $7! That and Proactiv, which really works miraculously well. I also do use Retin-A microgel(formulations other than microgel cause me to break out!). Try the less invasive stuff first as Accutane can have long term side effects and it is some pretty scary stuff. It was linked to suicidal depression, not the stuff I'd want to be taking during a gray and rainy Seattle winter!
Posted by z girl on January 18, 2009 at 3:36 PM
91
Accutane is fucking great. You look like a lizard for a few months, followed by a lifetime of near-perfect skin. And we're not talking a few pimples, we're talking covered-in-giant-zits-and-terrible-infections. Great stuff.

Mood swings? Wouldn't know. Bipolar--the manic kind. I'm super polite and sweet mostly now, but I will fight you with my fists if you talk in a movie theater.

Is that a side effect?
Posted by Me like. on January 18, 2009 at 3:52 PM
92
@37: women can't be sure that they don't want children until they've already had them or are past the childbearing age.

Seriously?
Posted by CDMelty on January 18, 2009 at 4:23 PM
93
To all you people saying "Why don't you try this, why don't you try that": Don't you fucking think that any person with half a brain would have tried just about EVERYTHING OUT THERE AND HAD IT FAIL before going on a drug with such serious potential side effects?

Benzoyl peroxide doesn't work.
Salicylic acid doesn't work.
Diet changes don't fucking work.
Proactive doesn't work.
Your homeopathic crap doesn't work.
Antibiotics don't work (and have their own crappy side effects).
Lasers don't work (plus, see above) and cost waaay too much.
Retin-A doesn't work.
Birth control doesn't frikkin' work (for zits).
All the 5+ topical prescription drugs for acne that I've tried DON"T WORK.

Hence, Accutane.
Thanks for coming out.
Posted by shut up on January 18, 2009 at 6:56 PM
94
To all you people saying "Why don't you try this, why don't you try that": Don't you fucking think that any person with half a brain would have tried just about EVERYTHING OUT THERE AND HAD IT FAIL before going on a drug with such serious potential side effects?

Benzoyl peroxide doesn't work.
Salicylic acid doesn't work.
Diet changes don't fucking work.
Proactive doesn't work.
Your homeopathic crap doesn't work.
Antibiotics don't work (and have their own crappy side effects).
Lasers don't work (plus, see above) and cost waaay too much.
Retin-A doesn't work.
Birth control doesn't frikkin' work (for zits).
All the 5+ topical prescription drugs for acne that I've tried DON"T WORK.

Hence, Accutane.
Thanks for coming out.
Posted by shut up on January 18, 2009 at 6:59 PM
95
Is your acne really that bad? When I get a pimple, I get it badddd, and I put a little dab of neosporin or triple antibiotic with pain relief on it at night and it clears up in the morning if I get a good 8 hours of sleep. Acne is a build up of staph bacteria... and I think some antibiotics/treatments may not work if their bacteria has developed a resistance to whatever remedies they're using. After I got a nasty MRSA infection and had to take sulfa antibiotics for it, I've had fewer problems with acne. So that's where my theory comes from.
Posted by kuribo on January 18, 2009 at 11:44 PM
96
@95 If your little pimple clears up overnight, then it's not "baddddd".

Baddddd is being 30 years old and still covered in 15+ huge, deep, painful pimples at once.
Posted by shut up on January 19, 2009 at 11:35 AM
97
SO. I’m 16 and have had acne since about the 5th grade honestly (my parents had it pretty bad esp. my mom...) I’ve tried "everything" and am on proactive now. When I first started using proactive it worked pretty dang well, but like everything else your skin and body gets use to it so it stopped working. Along with proactive being very expressive, I really feel like I deserve to try something else. Something that will work. I've known for as long as I can remember that I’m not having sex until I’m married so this whole birth defect thing isn't a concern for me, BUT as I’ve been reading peoples comments the suicidal topic is really freaking me out. I'm a happy person, but of course like everyone else in the world I get mad and annoyed. I really don't want to be suicidal or depressed though...UGH. I just want to try this stuff....what to do. what to do.
Posted by yomama on January 21, 2009 at 6:38 PM
98
Women who were warned of the dangers of getting pregnant on accutane and gave informed consent -- a verbal contract, which is legally binding -- cannot win their lawsuits, and won't get a single penny. Informed consent is not new. It existed before IPledge. The issue at play here had nothing to do with anyone losing money over accutane pregnancies and now needing to cover their behinds. This is the US government slowly stripping women of our privacy rights and freedom to make our own decisions about our bodies... Hmmm, ever hear the expression "slippery slope?" It does indeed seem as though women are being regarded by our government as potential incubators for fetuses rather than autonomous individuals. I don't care what they try to dress this up as. It's unacceptable.

Also, Ipledge is a shady organization seeking to profit monetarily from their government-backed monitoring program. They might have changed their privacy policy by now (due to being legally forced to) but they have/had been using the personal information they gained from the women they were monitering as a data mining technique so as to contact these privacy-stripped women with "offers," and they also reserved the right to share the personal information with unnamed "marketing partners." Um, this is called SPAM. That's who the government put in charge of highly sensitive medical records. Direct marketers. Spammers. Good job, USA!

Posted by Devora on January 30, 2009 at 4:01 PM
99
Women who were warned of the dangers of getting pregnant on accutane and gave informed consent -- a verbal contract, which is legally binding -- cannot win their lawsuits, and won't get a single penny. Informed consent is not new. It existed before IPledge. The issue at play here had nothing to do with anyone losing money over accutane pregnancies and now needing to cover their behinds. This is the US government slowly stripping women of our privacy rights and freedom to make our own decisions about our bodies... Hmmm, ever hear the expression "slippery slope?" It does indeed seem as though women are being regarded by our government as potential incubators for fetuses rather than autonomous individuals. I don't care what they try to dress this up as. It's unacceptable.

Also, Ipledge is a shady organization seeking to profit monetarily from their government-backed monitoring program. They might have changed their privacy policy by now (due to being legally forced to) but they have/had been using the personal information they gained from the women they were monitering as a data mining technique so as to contact these privacy-stripped women with "offers," and they also reserved the right to share the personal information with unnamed "marketing partners." Um, this is called SPAM. That's who the government put in charge of highly sensitive medical records. Direct marketers. Spammers. Good job, USA!

Posted by Devora on January 30, 2009 at 4:03 PM

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