I had to pay for this one.
A couple thoughts,
Accutane might inhibit natural vitamin a metabolism.
There was already a Vitamin A problem to begin with before Accutane as a cause of acne or poor skin.
The same enzymes involved in vitamin a metabolism might also metabolize androgens.
SUPPORTED BY AN EDUCATIONAL GRANT FROM
ROCHE DERMATOLOGICS INC.
This article supports the hypothesis that there might be reduced retinoid signaling in patients with
acne.
Interaction of isotretinoin with endogenous retinoids
Isotretinoin exhibits antiproliferative and antiandrogenic effects on the sebaceous glands by yet unknown mechanisms. This review focuses on a putative mechanism of action of isotretinoin involving the interaction of isotretinoin with the metabolism of endogenous retinoids and androgens.
Isotretinoin affects the endogenous retinol metabolism more than any other synthetic retinoid both in
vivo (epidermis and sebaceous glands) and in vitro (cultured keratinocytes), but why it affects them is not known.
“THE EFFECT OF ISOTRETINOIN ON
ENDOGENOUS RETINOL METABOLISM
MIGHT INVOLVE RETINOL
DEHYDROGENASES, WHICH ALSO
METABOLIZE ANDROGENS”
^Except Ive been looking at retinal dehydrogenases, but maybe any bottleneck in this process could have a trickle down effect.