It has two side effects, one of which is exceedingly important because, if ignored, it can cause devastating problems.

One side effect applies to pregnant women: Accutane taken during pregnancy can cause birth defects.

Obviously, Accutane should not be used by any woman who is pregnant or who intends to become so. A woman taking Accutane should not allow herself to become pregnant until at least 2 months after ending the use of this drug.

Admittedly, the risk of a birth defect due to Accutane, while real, is not large. And if a woman carefully practices birth control while taking Accutane, the risk of an unplanned pregnancy is small. Thus, from the danger that a baby might be born with a birth defect resulting from the use of Accutane is also very small. Nevertheless, we recommend against the use of Accutane by sexually active women of child- bearing age who would be unwilling to terminate a pregnancy.

The less problematic but sometimes still unpleasant side effects of Accutane have to do with a reduction in sebum production-the very method by which Accutane is effective against acne. Reduced sebum may result in severely dry skin, leading to nosebleeds, cracked lips, bleeding gums, a raspy throat, and other discomforts. Accutane can also cause more general symptoms such as headaches and occasionally even musculoskeletal problems. All of these are generally (but not always) mild. And they all cease as soon as the Accutane is discontinued.

In order to cure acne, all four phases of the disease must be eliminated. Once this is understood, and the cause of acne and the method by which it spreads is clear.