Like many teenagers, Allison Metzger, freshman in history, experienced the pain and embarrassment of acne.

When she was 16 years old, Metzger’s dermatologist told her about an extremely effective drug that could eliminate her acne. At first she thought it was a dream come true.

There are some people who don’t get the results they want from antibiotics and gels. They can be time consuming and sometimes the result is not worth the effort.

Some of these patients are willing to take the risk involved in a medicine called isotretinoin, which has proven effective in treating mild and severe cases that have been resistant to other forms of medication.

Isotretinoin is a retinoid, meaning it is derived from vitamin A. The compound works by reducing the amount of an oily substance, sebum, produced by the sebaceous glands.

Isotretinoin, also known as Accutane, Amnesteem, Claravis and Sotret, has been connected with several severe side effects. Some of them are certain and some are very rare, occurring mainly with abnormally high doses of the drug.

The most controversial side effect of isotretinoin is the severe birth defects that will likely occur if a female gets pregnant while on the drug.

Resulting birth defects include abnormalities of the face, skull, central nervous system and cardiovascular system.

From 16 women who got pregnant while on isotretinoin, six pregnancies ended in miscarriage, nine of the children were born with malformations and only one was born healthy, according to a study by the Centers for Disease Control and Prevention.

When Metzger was warned of the side effects and the procedures she would undergo, she and her parents decided it was not for her.

“I just thought the amount and the significance of the side effects was strange,” Metzger said. “Also, my parents didn’t want me on birth control that young.”

The Food and Drug Administration has gone to great lengths to reduce the amount of women who get pregnant while on isotretinoin.

In 2006, iPLEDGE was introduced to require pharmacists and any doctor who may prescribe the medicine to check the Web site regularly before writing or filling a patient’s prescription.

All patients must log onto the iPLEDGE Web site monthly, and using an ID number given by their doctor, the patient will be quizzed on the side effects of the drug and her sexual and menstrual history.

With iPLEDGE, the control has been taken from the doctors’ and pharmacists’ hands and has been given to the manufacturer of isotretinoin.

The program has the power to refuse treatment to a patient if all procedures are not followed, according to the iPLEDGE Web site.

Some other adverse effects listed for isotretinoin are: impaired night vision, cataracts, optic neuritis, menstrual disturbances, inflammatory bowel disease, hepatitis and stunted bone growth.

An extremely publicized side effect of isotretinoin is depression, although there is no proof of a causal relationship between the two.

There are numerous claims and lawsuits on behalf of patients who have either committed suicide or suffered from severe depression while on isotretinoin. However, no research has been able to positively link the isotretinoin with depression.

Kelly Beattie, ISU alumna, was on Accutane in high school.

“My lips were really dry and my face was peeling, but I never experienced any worse side effects than that,” Beattie said.

Dryness of skin and lips, photosensitivity and eye irritation are likely to occur in the course of isotretinoin, but the symptoms last no longer than a couple of weeks after treatment has stopped.

Like many other drugs, research shows a possibility of life-altering side effects in this isotretinoin treatment. However, these effects are either unlikely or avoidable.

Sara Arnold, pharmacist at Jennie Edmundson Hospital in Council Bluffs, firmly believes isotretinoin is not for everyone.

“It’s for people who have tried other things and it didn’t work for them; this is a last-resort drug,” Arnold said.

It’s the patients’ decision whether isotretinoin is worth the risk. However, with caution and awareness, it is possible to eliminate most potential problems.

“This is a decision that should be made between the patient and their doctor,” Arnold said. “It is not something the patient should jump into.”