Isotretinoin, the active ingredient in Accutane, dramatically reduces sebum production by shrinking sebaceous glands. This occurs through several mechanisms. It directly binds to retinoic acid receptors, altering gene expression and reducing the activity of enzymes involved in sebum synthesis.
While Accutane effectively treats acne by targeting sebum, paradoxical sebaceous hyperplasia can sometimes occur. This isn’t fully understood, but the initial suppression of sebum production may trigger a compensatory response. The skin might attempt to regain its previous sebum-producing capacity, potentially leading to the formation of larger, more noticeable sebaceous glands.
Factors influencing this risk include the total cumulative dose of isotretinoin, the patient’s genetic predisposition, and individual variations in skin response. Higher doses and longer treatment durations correlate with a slightly increased chance of hyperplasia.
While generally considered rare, hyperplasia often presents as small, yellowish papules, primarily on the face. It usually appears after treatment completion. Treatment options include laser therapies, such as CO2 laser ablation, offering a promising approach to reduce the appearance of these lesions.
Consult your dermatologist to discuss potential risks and management strategies, especially if you have a history of sebaceous hyperplasia or concerns about potential side effects.
