If you select links we provide, we may receive compensation.
Trigger warning: This article discusses suicide.
So we asked three top dermatologists our burning questions: How does Accutane work?
Who should take it?
And how much should you worry about the side effects?
Ahead, experts break down exactly how isotretinoin works and all the need-to-know details.
@theblemishqueen
Meet the Experts
What Is Isotretinoin?
Isotretinoin is an oral prescription medication derived from vitamin A that’s used to treat moderate-to-severe acne.
Isotretinoin is the closest thing to a cure for acne.
SeventyFour/ Getty Images
Accutane can be a life-changing medication for people who suffer from severe acne," King affirms.
“Its the gold standard for treating severe nodulocystic acne,” Obioha adds.
(Spironolactone causes breast growth in men).
When other acne medications fail to deliver for acne patients, derms often look to isotretinoin, Obioha explains.
How Does It Work?
People with deep, inflamed acne may have excess sebum in their skin, a symptom that isotretinoin targets.
If that’s music to your ears, Obioha agrees.
She calls isotretinoin “magical,” especially for patients at risk of scarring.
What Are the Side Effects?
SeventyFour/ Getty Images
There are quite a few potential side effects of isotretinoinbut the operative word here ispotential.
Dry skin and chapped lips are practically a given since isotretinoin stops your skin’s oil production.
“The most common side effect is drynessdry skin and chapped lips,” Obioha explains.
“The dryness is actually how we as dermatologists know the medication is being absorbed.”
“Other common side effects include elevations in blood lipid levels,” she adds.
Whether isotretinoin causes inflammatory bowel disease has been debated.
The potential isotretinoin side effects that have grabbed the most headlines are psychiatric.
“The relationship between isotretinoin and depression/suicide is not completely clear,” Obioha explains.
Justhavingsevere acne makes you more likely to become depressed and suicidal,she points out.
“The potential relation is something to be aware of and counsel patients about.”
Having a history of depression doesn’t mean you’re uninvited to the isotretinoin party, Obioha says.
But if you want to take the medication, be sure to seek support for your mental health.
What Is the iPledge Program?
“iPledge is a risk management program for isotretinoin,” Obioha explains.
iPledge requires isotretinoin patients of childbearing potential to use twoyes,twoforms of contraception while taking their meds.
Also, patients in the iPledge program have to repeatedly prove they’re not pregnant to get their prescriptions.
Should You Take Isotretinoin?
American Osteopathic College of Dermatology.Accutane.
2014;7(2 Suppl):S3-S21.
2015;1(2):10.15436/2378-6841.15.007.
2021;100(24):e26035.
doi:10.1097/MD.0000000000026035
Choi JS, Koren G, Nulman I.Pregnancy and isotretinoin therapy.CMAJ.
2013;185(5):411-413. doi:10.1503/cmaj.120729
