Acnetin-A 0.05/0.025 lotion is a drug with acne improving effects. It has Isotretinoin that is immersed among the other ingredients in the gel-like formulation of Acnetin. The drug is manufactured in the form of gel and cream. It is claimed to improve a lot of problems that include acne vulgaris and photodamaged skin. It is also sometimes used to improve wrinkles. Acnetin-A works by removing excess oil from the skin that would have eventually made the skin more prone to acne and other problems. It is advised to be kept at room temperature that does not exceed 25 degrees. For best results, it should be used for at least 4 to 6 weeks. Soft parts of the body like eyes should not be brought into contact with this drug. It must also be avoided in pregnancy and during lactation. The patients are advised to avoid the sun while using this cream.
About Sigma Pharmaceutical Industries
Sigma Pharmaceutical industries was first founded in 1998. The headquarters of this company are based in Queens, Egypt. The company claims to provide pharmaceutical products in various formulations to its customers across the Middle East.
Sigma foresees itself to get its name to the top pharmaceutical companies involved in the manufacturing of generic medicines in the whole of Middle East. Sigma Pharmaceutical Company says that it is its duty to achieve excellence in manufacturing medicines in order to improve health. The company strongly believes that in order to improve health, people need more access to cheap and great quality drugs. The company regards this as one of the reasons why it is struggling to be Middle East’s number one pharmaceutical industry. 
Clinical Research on Isotretinoin
Michael David et al explained about the adversities and side effects that occur due to the use of different retinoids like isotretinoin in his research paper titled as “Adverse Effects of Retinoids”. It was explained that retinoids are the man-made derivatives of vitamin A and how they have largely been applied in the management of a variety of skin diseases collectively known as dermatoses for decades. The most valuable drugs in this regard are found to be isotretinoin, also known as 13- cis-retinoic acid, for curing nodulocystic acne and etretinate for curing psoriasis Vulgaris in particular. Retinoids have also been found useful in the management of papulosquamous skin diseases apart from psoriasis which can be different disorders of keratinization that are inherited. In addition, retinoids are also used in the treatment of cutaneous T-cell lymphoma. Chemotherapy involves the use of these retinoids and they are also used in chemoprevention various cancers. Nonetheless, it has been noticed that these compounds, when administered in the body through any mode of entry, can cause a variety of mucocutaneous adversities. They have also been associated with toxicity of liver and irregularities in the plasma concentration of lipids and cholesterol. These lipid irregularities can lead to the augmented threat of coronary heart disease. Additionally, these retinoids have also been related to causing different birth defects in babies, therefore, termed as a teratogen in nature. They must be avoided in pregnancy because of this risk. Unremitting toxicities can occur due to the use of retinoids for a long period of time. These toxicities may include abnormalities of the skeleton and an occurrence of hyperostosis syndrome idiopathic in nature. In children, these retinoids may act as growth inhibitors causing a retention in their normal growth by closing the epiphyses of the bones prematurely. These abnormalities of the bones, however, are of reversible nature and the patients can recover from these side effects upon discontinuation of the retinoids. Other side effects caused by retinoids are not reversible. It was concluded that special techniques and procedures should be adopted by the physicians to curtail the side effects of these retinoids. 
“Comparison of depression, anxiety and life quality in acne vulgaris patients who were treated with either isotretinoin or topical agents” was the name of study supervised by Yesim Kaymak et al. The purpose of conducting this study was reported cases in which people undergoing treatment for acne with isotretinoin experienced depression, a high level of anxiety and even suicidal tendencies. This study involved comparison of these side effects in people who were taking oral isotretinoin with the people who were receiving topical therapy. 78 people undergoing therapy with isotretinoin were selected for this purpose. They were divided into two groups. 37 of them received isotretinoin while 41 were taking oral therapy and they were considered as the control group. The therapy continued for four months. During this duration, these patients were assessed for their psychological status at the start of the therapy. They were also checked at the second and fourth month of therapy. Their mood alterations were checked on the basis of the dermatology life quality index and a back depression inventory. Results were concluded. It was observed that both groups were same in terms of these assessment parameters at the start of the therapy. By the end of the second month, there was a deterioration seen the quality of life in the control group receiving topical therapy. Rest of the parameters remained the same among the groups. By the end of the fourth month, all these parameters in addition to the quality of life were improved in the patients receiving isotretinoin as compared to the control group. The study was wrapped up mentioning that isotretinoin played no role in the deterioration of mental health. Instead, it improved the psychological health of those using it for their acne. 
Description and Mechanism of Action of Isotretinoin
Isotretinoin is structurally a derivate of vitamin A which is involved in regulation of growth and proliferation of epithelial cells. Isotretinoin, when applied topically, stimulates the process of mitosis among the cells of the epidermis. It also helps reduce intercellular solidity seen in stratum corneum. It helps in desquamation of the cells and stops the formation of lesions. By the virtue of isotretinoin, less cohesive sebaceous cells are produced in the epidermis that causes a reduced production of comedones. It also serves as an anti-inflammatory substance by inhibiting the migration of WBCs towards the injured area. 
Acnetin-A 0.05/0.025 Effects for Acne and Wrinkles
Acnetin-A is prescribed for the sole purpose of treatment of acne and wrinkles. When given in higher doses, it can be used to reduce the scar and stretch marks and can even reduce drifting of the skin. Acnetin-A has also been reported to smoothen the skin and removing the spots. It shows crystal clear before and after results. 
Recommended Doses and Duration of Therapy
Isotretinoin containing gels should always be applied after consulting the doctor. The instructions should be properly followed. The affected area must first be washed thoroughly and must be dried. Acnetin-A gel must be applied in a thin layer in an amount sufficient to cover the affected area. Hands should be washed after application of the gel. The process can be repeated once or twice a day as per doctor’s instructions. If the patient had been using acne product previously that had resulted in peeling of skin, this product must be avoided until it is recovered. Soft parts of the body such as eyes must not come in contact with this drug. 
Side effects and Warnings
Since Acnetin-A is in form of a gel, the most common side effects of using this drug are the allergic reactions. Isotretinoin present in Acnetin-A can cause irritation on the area of application. Redness may also accompany this process. In addition, the skin of the patient may also get subjected to burning and drying. In some cases, peeling of skin has also been observed. IF any of these side effects occur, the best solution is to reduce the frequency of application of this gel for some time to check if the symptoms. If they still persist, the patient should contact a doctor. 
Isotretinoin is harmful when taken in the presence of pills that contain vitamin A or tetracyclines. It is advised to stop either drug prior to taking them on longer durations. Micodosed progesterone and Norethindrone/Ethinyl estradiol are also contraindicated in women who are taking these drugs. Doctors also prohibit the use of St.john’s wort and phenytoin with Isotretinoin. 
No user reviews could be found about Acnetin-A anywhere. This is an alarming situation as a complete lack of user reviews either suggests that the product is not known in the pharmaceutical world or that no one is using it because of its deleterious effects. Whatever the reason for the absence of user reviews is, it is not a good thing and definitely does not go in favor of Acnetin-A. Customer reviews provide an idea about how a particular drug works and tells others whether it is worth buying. Acnetin-A that has no reviews cannot be considered as a drug worth choosing for acne problems. The customers should instead plan on buying other alternatives that have isotretinoin in their basic formulae and customer reviews to support its authenticity and effectiveness.
Price, Available Forms, and Dosage
Acnetin is available for purchase from some pharmacy stores working online. It is available for buying from fouda.com in a gel form. The price per tube of Acnetin in gel formulation is set at the rate of 7 Egyptian Pounds or 0.39 US Dollars.
Unfortunately, the drug is not available for shipment to all countries. It is manufactured in Egypt and only available locally in the Egyptian market only. There are no pharmacies at present that provide shipping of this product to the United States, Canada, Australia and other countries across the world.
Acnetin is available in cream and gel formulations. The cream is advised to be used on the affected area in the form of a thin layer. It should be used once daily, preferably at bedtime. Further instructions can be obtained from the doctor in this regard.
Conclusion and Rating
Acnetin-A market value is practically zero. There is a reason for this. The drug is manufactured locally in Egypt and no company ships it to different areas of the world. Acnetin does have isotretinoin in its formula that fights acne problems actively but it does not have anything that makes it better than its alternatives which are available more easily. Not even a single reviews existed for this drug that I could get my hands on to get an idea about its effectiveness. I felt like this drug did not even exist for more than half of the world. The price is quite low but it doesn’t really matter because Acnetin cannot be purchased from local markets. To conclude, I could not find a single reason for choosing this brand over the others. I would give it 1 out of 5. Acnetin needs to be properly marketed and distributed in order to make a name for itself and improve its rating. I would advise acne patients to rely on other better alternatives for fighting their skin problems.
- Company Profile [Internet]. Wuzzuf. Available from: https://wuzzuf.net/jobs/careers/Sigma-Pharmaceutical-Industries-Egypt-11845
- David M, Hodak E, Lowe NJ. Adverse effects of retinoids. Medical toxicology and adverse drug experience. 1988 Aug 1;3(4):273-88. Available from: http://link.springer.com/article/10.1007/BF03259940
- Kaymak Y, Taner E, Taner Y. Comparison of depression, anxiety and life quality in acne vulgaris patients who were treated with either isotretinoin or topical agents. International journal of dermatology. 2009 Jan 1;48(1):41-6. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-4632.2009.03806.x/full
- Isotrex Gel [Internet]. Medicines. Available from: https://www.medicines.org.uk/emc/medicine/7503
- Acnetin- A 0.05% cream 7 G viatra tretinoin acne x 1 [Internet]. pharmathaistore. Available from: https://www.pharmathaistore.com/products/1252-acnetin-a-005-cream-7-g-vitara-tretinoin-acne-x-1.html
- Isotretinoin gel for acne (Isotrex) [Internet]. Patient.info. Available from: http://patient.info/medicine/isotretinoin-gel-for-acne-isotrex
- Isotretinoin side effects [Internet]. Ndrugs. Available from: http://www.ndrugs.com/?s=acnexcom/drugs/isotretinoin&t=side effects
- Accutane (Isotretinoin) – Drug Interactions, Contraindications, Overdosage, etc [Internet]. druglib. Available from: http://www.druglib.com/druginfo/accutane/interactions_overdosage_contraindications/