December 22, 2008
Dermatologists Warning Over New Rules for Acne Drug
New Zealand and Australian dermatologists are united in their criticism of PHARMAC’s decision to widen prescribing
rights for two medicines used to treat severe skin conditions.
The New Zealand Dermatological Society and The Australasian College of Dermatologists are worried that the current,
stringent, safety measures will not be upheld if the drugs are more easily prescribed.
Isotretinoin (commonly known as Roaccutane® and more recently as Isotane) and acitretin are potentially dangerous
medicines, used for the treatment of acne, psoriasis and other skin problems.
The drugs can have serious side effects, including an increased risk of birth defects if taken during or before
pregnancy (teratogenicity). For this reason, they have only previously been subsidised when prescribed by a specialist
PHARMAC’s decision means that from March next year General Practitioners and nurse practitioners will be able to
prescribe these medicines on a subsidised basis provided they have training and receive special authority from PHARMAC.
President of The New Zealand Dermatological Society Dr Liz Baird says, due to the severity of the potential side
effects local dermatologists have been conservative in the prescription of this medication.
“We know the potential damage that could be caused during a pregnancy would be devastating so we have been extremely
vigilant in ensuring our clients are fully informed of the importance of avoiding pregnancy while on these medications,”
says Dr Baird.
The New Zealand Dermatological Society and The Australasian College of Dermatologists agree with PHARMAC’s
acknowledgement that these medicines are potentially dangerous and require special precautions to ensure they are
prescribed and used safely. However, only dermatologists have specialist training in the treatment of skin conditions,
and extensive experience in prescribing these medicines.
The New Zealand Dermatological Society and The Australasian College of Dermatologists will be monitoring the training
given to general practitioners who wish to prescribe these medicines, to make sure they continue to be used safely and
Isotretinoin is a vitamin A derivative, which has been available for over two decades to treat severe nodulocystic acne
not responding to conventional treatment.
Severe acne is a difficult condition to treat and its therapy requires significant training, particularly with regard to
the use of isotretinoin. This is a medication that has many dermatological side effects which often need to be
separately managed during the course of treatment.
In Australia and the United Kingdom both medicines are still strictly specialist only. The United States has also
recently tightened up prescription ofisotretinoin with the iPledge programme – where close monitoring of patients is
Notes to editors:
The New Zealand Dermatological Society Inc:
The New Zealand Dermatological Society Inc. is a non profit, professional society of dermatologists which aims to
support and promote dermatology and to provide an authoritative body of opinion on matters of the skin. The society
represents all dermatologists in New Zealand and provides continuing professional development and scientific meetings
for its members as well as providing a voice for dermatologists in discussion with Government and affiliated health
The society accepts as members only dermatologists that are vocationally registered with the New Zealand Medical
Council. Dermatologists are the medical and surgical skin specialists and usually have completed at least four to six
years of study in dermatology.
Dr Elizabeth A. Baird, MB ChB, FRACP, Dip GU Med (Lond)
Dr Baird is a UK graduate who moved to New Zealand in 1985. She completed her dermatology training in New Zealand and
Scotland and has been practicing clinical dermatology in Auckland for the past 16 years.
Dr Baird’s special interests are in the treatment of acne, eczema and management of skin cancer. Dr Baird is the current
president of The New Zealand Dermatological Society and is a Fellow at the Royal Australasian College of Physicians and
American Academy of Dermatology. She is also a member of the DermNet Education Group.