Dr. Bremner’s findings call for further investigation of drug isotretinoin. However, insufficient funding may impede such a study. The American Academy of Dermatology wants clinical trials to prove that isotretinoin causes depression or “psychiatric events” before it encourages stronger warnings and tighter regulations of acne drug. Yet, FDA does not have funding to cover testing.

While delving into affects of Accutane Dr. Bremner has come to agree with David J. Graham, MD, MPH- Associate Director for Science and Medicine in FDA’s Office of Drug Safety. Graham warns that Accutane should be taken off market.

Dr. David Graham paints a daunting image of how FDA determines a drug’s safely. He relates that using Center for Drug Evaluation and Research’s (CDER) standard for drug safety to a pistol holding 100 chambers. The gun symbolizes a drug while bullets represent a serious safety problem with drug. “Using CDER’s standard, only when you have 95 bullets or more in gun will you agree that gun is loaded and a safety problem exists,” explains Dr. Graham. He adds that if only 90 bullets were in chamber, CDER would conclude that gun is not loaded and drug is therefore safe.

The FDA is strengthening its risk minimization action plan (RiskMAP) for Accutane and generic version of isotretinoin in hopes of reducing possibility of birth defects associated with fetal exposure to acne drug. Women will now have to present negative pregnancy tests before filling their isotretinoin prescription each month. Some dermatologists have practiced this pregnancy monitoring without prodding from FDA. This new measure makes no mention of depression or suicide that may result from isotretinoin usage.

Dr. Bremner adds that patients taking isotretinoin have to be asked about depression, they don’t just openly talk about it. Discussing symptoms of depression is an added measure that doctors prescribing isotretinoin can make to ensure well-being of their patients.

It’s great to live in a country that inspires enterprise, invention and independence. All these things come with a price. The buyer gets to decide how much they’re willing to pay. The FDA exists to protect consumer. Whether you feel FDA’s efforts are insufficient or overbearing, you have medical options. Geoffrey Redmond MD, author of The Good News about Women’s Hormones, suggests using hormone therapy and/or using Retin-A if Accutane seems too risky.

Another investigation aiming to demystify acne came for Dr. Loren Cordain. Cordain and his associates explored link between diet and acne in a study called Acne Vulgaris: A Disease of Western Civilization. Cordain noted that Kitavan Islanders of Papua New Guinea and Aché hunter-gatherers of Paraguay had no active cases of acne. This prompted question, “So why does acne vulgaris affect 79% to 95% of adolescent population in westernized societies?”

Cordain found that genes alone do not cause disparity of acne incidences between non-westernized and modernized societies. Other factors must enter equation.

Acne can arise from hormonal shifts, stress upheavals and a host of other causes. Your best defense against acne is observing yourself and noting what conditions, foods and emotions aggravate your acne situation. From there, you can use self-care to reduce acne flare-ups.