Isotretinoin (Accutane)

Isotretinoin, often known by the old brand name Accutane, is an oral medicine for severe acne and acne that has not cleared with other treatments. It can produce long-lasting improvement after a course, although acne may return.

It is a powerful medicine, so treatment involves regular visits and monitoring.

Who it may help

• Severe acne with deep, painful cysts or nodules
• Acne that is leaving scars
• Acne that has not improved with creams and antibiotics
• Acne that keeps coming back after other treatment

What to expect

Starting treatment

Your provider reviews your health history and orders blood tests. Everyone prescribed isotretinoin in the United States must enroll in iPLEDGE. Patients who can become pregnant must follow its pregnancy-testing and pregnancy-prevention requirements, using the required contraception or qualifying continuous abstinence. Pregnancy must be avoided for one month before treatment, during treatment and for one month afterward because isotretinoin can cause severe birth defects. Your prescriber will explain the current requirements.

During treatment

A course often lasts several months; duration depends on your dose and response. You come in monthly so we can check your progress, adjust your dose and arrange blood tests when needed.

Common side effects

Dry lips, dry skin, dry eyes and nosebleeds are very common. Some people have muscle aches or a brief flare of acne at the start. We will talk about rare but serious side effects, including mood changes, and what to report right away.

Where it is offered

Isotretinoin Q&A

Related care

• Acne
• AviClear
• Acne scar treatment