Accutane and Birth Defects

A friend of mine took Accutane to clear up her skin, and it looks great. I heard that it causes severe birth defects, is it worth taking?
Accutane has manageable side effects for a woman, but it can lead to very serious birth defects in her child It is supposed to be prescribed only to women who have severe or resistant acne that has not responded to any other form of treatment. Studies show instead that Accutane is often misused and is given to women of childbearing age who have not exhausted other treatment options, or who do not show severe cystic acne. There are strict guidelines under which a doctor should prescribe Accutane. A woman must first be given a pregnancy test, two weeks to a month before starting Accutane. She must also use an oral contraceptive in addition to a backup method such as a condom, unless she practices abstinence. And regular pregnancy tests should be taken throughout treatment. Although these guidelines are strongly encouraged, they are at times ignored. The consequences are serious. 25% of children born to women who were using Accutane while pregnant have birth defects that include brain and nervous system damage. Because there are other drugs available for the treatment of acne, and acne itself is not life threatening, it is recommended that any woman who either intends to get pregnant in the near future should avoid taking Accutane.

The normal course of treatment with Accutane runs about 15-20 weeks, and is effective for roughly a year after treatment. Because it is a drug that remains in the system for quite some time it is advised that a woman using Accutane also avoid pregnancy for at least two months after she has finished her course of treatment. Women who are breastfeeding are also warned not to use Accutane, as it is still unclear whether this can have a negative effect on a child's development. Accutane's topical counterpart--Retin-A has not been shown to cause these birth defects. However, careful controlled studies have not been done. It would be the cautious thing to do to discontinue Retin-A and substitute a safe alternative such as benzoyl peroxide.

Some of the common side effects for women are burning itchy eyes, nosebleeds, itchy skin, chapped lips, and dry mouth. Less frequently people experience joint and muscle pain. There is still some question about what the side effects of long-term use are. If a woman repeatedly uses Accutane for long periods of time she should be monitored for liver and cornea damage. Accutane should really only be taken for severe or resistant acne, under a doctor's supervision.

REFERENCES
a listing of scientific articles and texts used.