Isotretinoin: Overview
Isotretinoin (eye-soh-tret-in-OH-in) is a prescription medication for severe acne. This type of acne causes deep, painful cysts and nodules, which can be the size of a pencil eraser or larger. As this acne clears, scars often appear.
Severe acne can be difficult to treat. When other treatments fail to clear the skin, isotretinoin may be an option. Treatment with isotretinoin often results in prolonged clearance of acne, which can be permanent for some patients.
Brand names for isotretinoin include Absorica®, Amnesteem®, Claravis®, Myorisan®, and Zenatane™. Some people refer to this medication as Accutane®. This is a brand of isotretinoin that is no longer available.
Warning: When you buy this medication from an online site that does not require a prescription, you put your health at serious risk.
One course of treatment takes about four to five months. Sometimes, one course of treatment takes less time or a bit more time. Dermatologists tailor the treatment to each patient.
Your safety is a dermatologist's first concern. Due to possible side effects, your dermatologist will talk with you about the risks and benefits of isotretinoin and about your health.
This will help your dermatologist decide whether this medication is an option for you. If it is, your dermatologist will share educational materials with you. This can help you decide if you want to take isotretinoin.
If you and your dermatologist decide that isotretinoin is the right choice for you, your dermatologist will enroll you in a risk-management program called iPLEDGE® REMS. The U.S. Food and Drug Administration (FDA) runs this program, which helps to:
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Prevent a patient from starting isotretinoin while pregnant.
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Prevent a patient from becoming pregnant while taking isotretinoin.
This program also helps your dermatologist monitor you while taking isotretinoin. A prescription is good for a 30-day supply of isotretinoin. To get another prescription, you must:
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See your dermatologist every 30 days for follow-up visit, either in-person or by telemedicine.
Patients who can become pregnant must take a few extra precautions:
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Take the required pregnancy tests before and while taking isotretinoin.
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Avoid getting pregnant.
All of these precautions mean that you will be under close medical supervision while taking isotretinoin.
Related AAD resources
Last updated: 12/15/21
All content solely developed by the American Academy of Dermatology
Isotretinoin: Benefits and risks
This medicine treats many patients safely and effectively. However, it is not right for everyone. You should discuss the benefits and risks with your dermatologist.
When you talk with your dermatologist about isotretinoin, be sure to tell your dermatologist if you have any of the following:
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Disease that affects your immune system, such as HIV, AIDS, rheumatoid arthritis (RA), psoriasis, or graft vs. host disease
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Allergies
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Plans to become pregnant, or are pregnant or breastfeeding
“Isotretinoin offers our patients who have severe acne significant, life-changing benefits. Providing this medicine safely is our top priority.”
─ Dermatologist William D. James, MD, FAAD
You also should tell your dermatologist if you take:
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Any medicine (include ones you buy without a prescription, such as aspirin)
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Vitamins
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Minerals
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Herbal supplements
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Any other acne treatment, including antibiotics
Be sure to tell your dermatologist about all acne treatments that you have used in the past and the results from each.
Talk with your dermatologist about concerns
If you have any concerns about taking isotretinoin, you should tell your dermatologist. Dermatologists have been prescribing this medicine for years. In fact, dermatologists led many of the clinical trials for isotretinoin. This makes dermatologists very familiar with the medicine and knowledgeable about whom it can help.
Dermatologists continue to lead research studies that look at how isotretinoin can help improve the lives of their patients.
Related AAD resource
More resources
Last updated: 12/15/21
All content solely developed by the American Academy of Dermatology
Isotretinoin: The truth about side effects
Having trouble getting your acne medication?
The AADA is advocating to find a solution to help patients get the isotretinoin they need. Patients can help us by sharing their stories.
Share your storyDermatologists prescribe isotretinoin to treat deep, painful acne cysts and nodules. When other treatment fails, this medication can diminish or clear severe acne and prevent new acne scars.
You may have heard this medication called Accutane® instead of isotretinoin. Accutane is a brand name of isotretinoin that is no longer available.
Whether you call it Accutane or isotretinoin, myths and misconceptions about this medication are common. This is especially when it comes to side effects. It's important to remember that all medications have potential side effects. Here’s what you should know about the possible side effects of isotretinoin.
Side effects: What we know
Pregnancy risks: If a person takes isotretinoin while pregnant, this medication can cause:
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Severe birth defects
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Miscarriage
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Stillbirth
Prevent pregnancy risks: To get a prescription for isotretinoin, a patient who can become pregnant must take two pregnancy tests to make sure they're not pregnant. Patients who can get pregnant must also agree that while taking this medication, they will have a monthly pregnancy test and use two forms of birth control.
Dryness: It’s common to experience one or more of the following while taking isotretinoin:
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Dry skin, severely chapped lips
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Nosebleeds
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Dry, irritated eyes
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Dry mouth
Applying an oil-free moisturizer can reduce dryness without causing breakouts
Moisturizer works best when you apply it immediately after washing.
Treat dryness: Once you stop taking the medication, dryness will clear. Until then, you can get relief with moisturizer, lip balm, and artificial tears. For nosebleeds, apply petroleum jelly just inside your nose. This helps keep the tissue moist, which can prevent nosebleeds.
Sun-sensitive skin: When you take isotretinoin, you may become extremely sensitive to the sun.
Protect your skin from the sun while taking isotretinoin
This medication can make your skin more sensitive to the sun. You can sunburn quickly and unexpectedly.
Manage sun-sensitive skin: To protect your skin from the sun, dermatologists recommend that you Practice Safe Sun. Your dermatologist may also give you other tips. Once you stop taking isotretinoin, this sensitivity will go away.
Acne worsens: Because isotretinoin effectively treats so many people with severe acne, many people are surprised by this possible side effect.
When you start taking isotretinoin, acne may worsen
This possible side effect is temporary.
Worsening acne is a temporary side effect: When you start taking isotretinoin, acne can worsen for 1-2 months before it begins to clear. This happens with many other acne treatments.
Can affect your eyesight, hair, muscles, or joints: While taking isotretinoin, you may develop:
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Trouble seeing at night (night blindness)
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Thinning hair
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Muscle (or joint) pain
These side effects are temporary: When you stop taking isotretinoin, these side effects tend to go away. If you experience thinning hair, your hair should grow back.
Other possible side effects: When taking isotretinoin, other concerning side effects may occur. These include:
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Rash
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Stomach problems
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Unhealthy cholesterol levels
If you develop any of these side effects, contact your dermatologist.
Uncommon side effects include:
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Increasing pressure on the brain, which can lead to problems with your eyesight, permanent loss of eyesight, and, in rare cases, death.
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Liver damage
While you’re taking isotretinoin, your dermatologist will monitor you closely. That’s why patients need certain tests like pregnancy tests and blood tests.
Side effects: What we need to learn
While some people have reported the following serious side effects, we don't have enough evidence to know whether isotretinoin is linked to or can cause the following:
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Depression
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Thoughts of committing suicide
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Inflammatory bowel disease (IBD)
Researchers continue to study isotretinoin and possible side effects
Dermatologists use findings from this research to help their patients decide whether to take isotretinoin and to watch their patients for signs of side effects.
What we do know: It’s possible that having severe acne increases the risk of developing these side effects. Research shows that people who have severe acne can become depressed. This is true for people who take isotretinoin and for those who don't. Some people who have severe acne develop such a deep depression that they think about taking their own life. When acne clears, the depression and thoughts of suicide also tend to disappear.
When a patient with acne develops depression, dermatologists take this seriously. They are trained to spot warning signs that a patient could be depressed. Before prescribing isotretinoin, dermatologists also screen patients carefully for possible signs of depression and thoughts of suicide. This helps them determine if the medication is a good option for you.
Researchers have also studied the connection between acne and IBD. While some studies suggest that taking isotretinoin may increase the risk of developing IBD, other studies have not found this to be true.
To find out whether this medication can cause IBD, researchers continue to study this possible side effect. This research takes time. Researchers have to account for many considerations. For example, it's possible that the genes which increase your risk of having severe acne also increase your risk of developing IBD.
Dermatologists monitor each patient
Before prescribing isotretinoin, your dermatologist will talk with you about your acne and give you information about isotretinoin. This can help you decide whether this medication is right for you.
If you and your dermatologist decide that isotretinoin is the right treatment, your dermatologist will watch for warning signs of side effects. You will meet with your dermatologist every 30 days, either in-person or through telemedicine. This allows your dermatologist to check in with you to see how you’re doing. If all is well, your dermatologist can write another 30-day prescription for isotretinoin.
Writing a new prescription every 30 days is a safeguard that helps protect your health. In the United States, a doctor can only prescribe isotretinoin for 30 days. To get another prescription, you need to check in with your dermatologist.
During your check-ins, tell your dermatologist how you feel, even if it seems unrelated to taking isotretinoin.
Other side effects, aside from the ones listed above, are possible.
Your dermatologist can help you sort out what’s happening.
Related AAD resources
Images
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References
Huang YC and Chen YC.” Isotretinoin treatment for acne and risk of depression: A systematic review and meta-analysis.” J Am Acad Dermatol 2017;76:1068-76.
iPLEDGE Program, Last accessed December 2021.
Lee SY, Jamal MM, et al. “Does exposure to isotretinoin increase the risk for the development of inflammatory bowel disease? A meta-analysis.” Eur J Gastroenterol Hepatol. 2016 Feb;28(2):210-6.
Racine A, Cuerq A, et al. “Isotretinoin and risk of inflammatory bowel disease: a French nationwide study.” Am J Gastroenterol. 2014;109(4):563-9.
Rashtak S, Khaleghi S, et al. “Isotretinoin exposure and risk of inflammatory bowel disease.” JAMA Dermatol. 2014;150(12):1322-6.
Soundararajan V, Gwillim E, et al. “Poster 8292 Frequency of depression in dermatologist-managed patients who have acne, isotretinoin-exposure vs no isotretinoin exposure: Pharmacovigilance analysis of a large Midwestern US population from the RADAR (Research on Adverse Drug events And Reports) program.” J Am Acad Dermatol 2019;81: suppl 1, AB67.
U.S. National Library of Medicine, “Identifying the genetic predictors of severe acne vulgaris and the outcome of oral isotretinoin treatment (SA).” ClinicalTrials.gov Identifier: NCT01727440. Last accessed February 2020.
Zaenglein AL, Pathy AL, et al. “Guidelines of care for the management of acne vulgaris.” J Am Acad Dermatol 2016;74:945-73.
Last updated: 12/15/21
All content solely developed by the American Academy of Dermatology
Isotretinoin: Patient safety
News of lawsuits and frightening side effects can make one wonder why a dermatologist would prescribe isotretinoin (eye-soh-tret-in-OH-in)1. Furthermore, why would anyone take it to treat acne? There really is more to the story.
Effective when nothing else works
Dermatologists prescribe isotretinoin for severe acne. Severe acne is often very painful. When the painful cysts and nodules of severe acne clear, they leave permanent scars. Many people who have severe acne feel depressed. Some feel anxious. Low self-esteem often develops. Grades can plummet, and job performance can suffer.
Clearing severe acne greatly improves many people’s lives. Most acne treatments, however, have little effect on severe acne.
Isotretinoin can clear severe acne when other treatments fail. With just one treatment, isotretinoin can permanently clear the skin. One treatment typically lasts four to five months. If a dermatologist prescribes a lower dose of isotretinoin, the treatment may last longer. Treatment with isotretinoin often results in prolonged clearance of acne, which can be permanent for some patients.
Isotretinoin is strong medicine. It has the potential to cause some serious side effects. That’s why dermatologists carefully evaluate each patient. They weigh the pros and cons before prescribing isotretinoin. They carefully monitor every patient taking this medicine.
Dermatologists evaluate patients
Before prescribing isotretinoin, dermatologists ask questions about the patient’s physical and mental health. They ask what medicines, vitamins, and herbal supplements the patient takes. If everything looks OK, the patient must get a few medical tests. Everyone needs a blood test. Patients who can get pregnant must have 2 negative pregnancy tests before isotretinoin can be prescribed.
Before prescribing isotretinoin, the dermatologist looks at the test results. If the results are okay, the dermatologist will discuss possible side effects of isotretinoin. After learning about isotretinoin, a patient must decide whether to take this medicine.
If the patient wants to take it, the patient must agree to the strict terms of the iPLEDGE®program. iPLEDGE was created to help patients take this medication seriously. The terms that the patient must agree to include:
-
See your dermatologist every 30 days, either in person or by telemedicine.
-
Take the necessary medical tests.
Patients monitored
The office visits and medical tests allow a dermatologist to look for early warning signs of possible side effects and determine how well the medicine is working. The dermatologist will look for signs of depression, inflammatory bowel disease, and other possible side effects.
Before writing the next prescription, the dermatologist must be convinced that the patient is doing well and following iPLEDGE.
Depression and isotretinoin
Many people worry that isotretinoin can cause mental health conditions. There have been reports of patients developing depression, seeing and hearing things that are not real, and having thoughts of suicide while taking isotretinoin. You may have heard such reports in the news.
Isotretinoin and depression
Some patients have suffered from depression while taking isotretinoin, but more research is needed to determine if the drug is the cause.
Dermatologists take these reports seriously. That’s why dermatologists are conducting research studies to find out whether isotretinoin is directly responsible. Proving or disproving this is not as easy as it sounds. One reason is research shows that people who have severe acne often become depressed. This is true for people who have never taken isotretinoin.
Because we do not have enough evidence to tell whether this medicine can cause depression and other mental health conditions, dermatologists look for warning signs of depression and other mental health conditions.
Dermatologists also recommend taking precautions. If a person taking isotretinoin has any symptoms of depression or another mental health condition, the person must stop taking isotretinoin right away.
Inflammatory bowel disease and isotretinoin
Inflammatory bowel disease (IBD) is another concern. There have been reports of patients developing IBD while taking isotretinoin. Again, there is not enough scientific evidence to determine whether isotretinoin is actually the cause. More research is needed.
If a patient develops any of the following signs or symptoms of IBD, the patient must stop taking isotretinoin and see a doctor:
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Severe stomach or bowel (intestines) pain
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Diarrhea
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Bleeding from rectum
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Yellowing of skin or eyes
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Dark urine
Patient safety is the first priority
Isotretinoin is an important medicine. It can clear severe acne that does not respond to any other treatment. As acne clears, a patient’s quality of life often greatly improves. Dermatologists are committed to the safe and responsible use of this medicine. Patient safety is a dermatologist’s first priority when prescribing isotretinoin.
1 Isotretinoin is the generic name for this medication. Many people know this medication by the brand name Accutane®, which is no longer available. Isotretinoin is available through other brand names.
References
American Academy of Dermatology and AAD Association, “Position Statement on Isotretinoin, (last update November 13, 2010).
American Academy of Dermatology, “AADA introduces updated isotretinoin position statement.” News releases issued November 22, 2010.
Chiu V, Cheng A, Oliver D, “Isotretinoin and association with depression.” Presented as a poster (P704) at the 68th Annual Meeting of the American Academy of Dermatology, March 2010; Miami. (Commercial support: None identified).
Hodgkiss-Harlow CJ, Eichenfield LF, Dohil MA. “Effective monitoring of isotretinoin safety in a pediatric dermatology population: A novel "patient symptom survey" approach.” J Am Acad Dermatol 2011; 65: 517-24.
Crockett SD, Gulati A, Sandler RS et al. “A causal association between isotretinoin and inflammatory bowel disease has yet to be established.” Am J Gastroenterol 2009; 104: 2387-93.
Goldsmith LA, Bolognia JL, Callen JP et al. “American Academy of Dermatology Consensus Conference on the safe and optimal use of isotretinoin: summary and recommendations.” J Am Acad Dermatol 2004; 50: 900-6.
Magin P, Pond D, Smith W. “Isotretinoin, depression and suicide: a review of the evidence.” Br J Gen Pract 2005; 55: 134-8.
Strauss JS, Krowchuk DP, Leyden JJ et al. “Guidelines of care for acne vulgaris management.” J Am Acad Dermatol 2007; 56: 651-63.
Wysowski DK, Beitz J. "Methodological limitations of the study: Isotretinoin use and risk of depression, psychotic symptoms, suicide, and attempted suicide." Arch Dermatol 2001; 137: 1102-3.
Wysowski DK, Pitts M, Beitz J. “An analysis of reports of depression and suicide in patients treated with isotretinoin.” J Am Acad Dermatol 2001; 45: 515-9.
Last updated: 12/15/21
All content solely developed by the American Academy of Dermatology
Isotretinoin: FAQs
Will isotretinoin cure me?
Treatment with isotretinoin often results in prolonged clearance of acne, which can be permanent for some patients. A course of treatment generally lasts about 4 to 5 months. It can run shorter or longer.
Some patients do not clear after one course of treatment, and a second course of treatment may be an option. Studies show this helps some patients see clear skin. You should wait at least 8 weeks between treatments. The skin often continues to clear for a while after patients stop taking the medication.
How do I use isotretinoin?
This medication comes in pill form. You will take one or two pills a day as your dermatologist prescribes.
Before taking isotretinoin, your dermatologist will enroll you in a risk-managment program called the iPLEDGE® REMS. Created by the U.S. Food and Drug Administration (FDA), this program helps to ensure that patients:
-
Do not start taking isotretinoin while pregnant.
-
Do not become pregnant while taking isotretinoin.
Because iPLEDGE REMS informs patients about other possible side effects, all patients must be enrolled in this program before taking isotretinoin .
How long will I have to take isotretinoin?
One course of treatment generally takes about 4 to 5 months. You may need a shorter or longer treatment time.
How does isotretinoin work?
This is the only acne treatment that attacks all four causes of acne—excess oil production, clogged pores in the skin, too much of the bacteria P. acnes, and inflammation. This makes isotretinoin very effective.
Do I need to take any precautions while using isotretinoin?
Yes. You will need to learn about the potential side effects before you decide whether to take isotretinoin.
If you and your dermatologist decide that this medication is right for you, your dermatologist will enroll you in a risk-management program. While taking isotretinoin, you will need to do the following:
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See your dermatologist every 30 days for a follow-up appointment, either in-person or by telemedicine.
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Immediately report any possible side effect to your dermatologist.
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Do not wax to remove hair while taking this medicine, and for 6 months after you stop taking isotretinoin.
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Protect your skin from the sun and do not use a tanning bed, sun lamp, or other indoor tanning device.
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Do not donate blood while taking isotretinoin and for 30 days after you take your last pill.
Patients who can get pregnant also need to take the following precautions:
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Take the required pregnancy tests.
-
Use two approved forms of birth control or do not have sex or any sexual contact.
Isotretinoin and pregnancy
It is especially important to not be pregnant or become pregnant while taking isotretinoin.
What are the possible side effects?
A number of possible side effects can occur while taking this medicine.
You can learn about the safeguards that help prevent side effects, at: Isotretinoin: The truth about side effects.
Is it safe to remove hair with wax while taking isotretinoin?
No waxing, please. Waxing can cause permanent scars in people taking isotretinoin. To avoid scarring, you must not wax while taking isotretinoin and for six months after you stop taking isotretinoin. This applies to hot wax and cold wax.
Does isotretinoin increase risk of sunburn?
If you plan to spend time outdoors, it is important to know that isotretinoin can make your skin more sensitive to the sun. You can sunburn unexpectedly and quickly. To protect your skin, dermatologists recommend that people taking isotretinoin:
-
Seek shade when outdoors.
-
Wear sun-protective clothing, such as lightweight, long-sleeved shirt, pants, and a wide-brimmed hat.
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Apply sunscreen to all skin not covered by clothing.
Isotretinoin: Think sun protection
It is important that patients taking isotretinoin protect their skin from the sun.
The type of sunscreen you use is important. Be sure to use sunscreen that offers:
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Broad-spectrum protection (bottle may say “UVA/UVB protection”)
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An SPF of 30 or greater
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Water resistance
Because isotretinoin can make your skin more sensitive, it is especially important that you not tan. This includes not using indoor tanning (sunlamps and tanning beds) while taking isotretinoin.
Reference
Elminan M, Bird ST, Delaney JA et al. “Isotretinoin and Risk for Inflammatory Bowel Disease.” JAMA Dermatol. 2013 Feb 1;149(2):216-20.
Last updated: 12/15/21
All content solely developed by the American Academy of Dermatology
Isotretinoin: Patient safety
News of lawsuits and frightening side effects can make one wonder why a dermatologist would prescribe isotretinoin (eye-soh-tret-in-OH-in)1. Furthermore, why would anyone take it to treat acne? There really is more to the story.
Effective when nothing else works
Dermatologists prescribe isotretinoin for severe acne. Severe acne is often very painful. When the painful cysts and nodules of severe acne clear, they leave permanent scars. Many people who have severe acne feel depressed. Some feel anxious. Low self-esteem often develops. Grades can plummet, and job performance can suffer.
Clearing severe acne greatly improves many people’s lives. Most acne treatments, however, have little effect on severe acne.
Isotretinoin can clear severe acne when other treatments fail. With just one treatment, isotretinoin can permanently clear the skin. One treatment typically lasts 4 to 5 months. If a dermatologist prescribes a lower dose of isotretinoin, the treatment may last longer. About 85% of patients see permanent clearing after one treatment.
Isotretinoin is strong medicine. It has the potential to cause some serious side effects. That’s why dermatologists carefully evaluate each patient. They weigh the pros and cons before prescribing isotretinoin. They carefully monitor every patient taking this medicine.
Dermatologists carefully evaluate patients
Before prescribing isotretinoin, dermatologists ask questions about the patient’s physical and mental health. They ask what medicines, vitamins and herbal supplements the patient takes. If everything looks okay, the patient must get a few medical tests. Everyone needs a blood test. Women who can get pregnant must have pregnancy tests. Women need 2 negative pregnancy tests before isotretinoin can be prescribed.
Before prescribing isotretinoin, the dermatologist looks at the test results. If the results are okay, the dermatologist will discuss possible side effects of isotretinoin. After learning about isotretinoin, a patient must decide whether to take this medicine.
If the patient wants to take it, the patient must agree to the strict terms of the iPLEDGE program. iPLEDGE was created to help patients take this medicine seriously. The terms that the patient must agree to include:
- See the dermatologist every 30 days.
- Take the necessary medical tests.
Patients carefully monitored
The office visits and medical tests allow a dermatologist to look for early warning signs of possible side effects and determine how well the medicine is working. The dermatologist will look for signs of depression, inflammatory bowel disease, and other possible side effects.
Before writing the next prescription, the dermatologist must be convinced that the patient is doing well and following iPLEDGE.
Depression and isotretinoin
Many people worry that isotretinoin can cause mental health conditions. There have been reports of patients developing depression, seeing and hearing things that are not real, and having thoughts of suicide while taking isotretinoin. You may have heard such reports in the news.
Dermatologists take these reports seriously. That’s why dermatologists are conducting research studies to find out whether isotretinoin is directly responsible. Proving or disproving this is not as easy as it sounds. One reason is research shows that people who have severe acne often become depressed. This is true for people who have never taken isotretinoin.
Because we do not have enough evidence to tell whether this medicine can cause depression and other mental health conditions, dermatologists carefully monitor their patients for warning signs of depression and other mental health conditions.
Dermatologists also recommend taking precautions. If a person taking isotretinoin has any symptoms of depression or another mental health condition, the person must stop taking isotretinoin right away.
Inflammatory bowel disease and isotretinoin
Inflammatory bowel disease (IBD) is another concern. There have been reports of patients developing IBD while taking isotretinoin. Again, there is not enough scientific evidence to determine whether isotretinoin is actually the cause. More research is needed.
If a patient develops any of the following signs or symptoms of IBD, the patient must stop taking isotretinoin and see a doctor:
- Severe stomach or bowel (intestines) pain.
- Diarrhea.
- Bleeding from rectum.
- Yellowing of skin or eyes.
- Dark urine.
Patient safety is the first priority
Isotretinoin is an important medicine. It can clear severe acne that does not respond to any other treatment. As acne clears, a patient’s quality of life often greatly improves. Dermatologists are committed to the safe and responsible use of this medicine. Patient safety is a dermatologist’s first priority when prescribing isotretinoin.
1Isotretinoin is the generic name for this drug. Many people know this drug by the brand name Accutane, which is no longer available. Isotretinoin is available through other brand names.
References
American Academy of Dermatology and AAD Association, “Position Statement on Isotretinoin, (last update November 13, 2010).
American Academy of Dermatology, “AADA introduces updated isotretinoin position statement.” News releases issued November 22, 2010.
Chiu V, Cheng A, Oliver D, “Isotretinoin and association with depression.” Presented as a poster (P704) at the 68th Annual Meeting of the American Academy of Dermatology, March 2010; Miami.(Commercial support: None identified).
Hodgkiss-Harlow CJ, Eichenfield LF, Dohil MA. “Effective monitoring of isotretinoin safety in a pediatric dermatology population: A novel "patient symptom survey" approach.” J Am Acad Dermatol; 2011; 65: 517-24.
Crockett SD, Gulati A, Sandler RS et al. “A causal association between isotretinoin and inflammatory bowel disease has yet to be established.” Am J Gastroenterol 2009; 104: 2387-93.
Goldsmith LA, Bolognia JL, Callen JP et al. “American Academy of Dermatology Consensus Conference on the safe and optimal use of isotretinoin: summary and recommendations.” J Am Acad Dermatol 2004; 50: 900-6.
Magin P, Pond D, Smith W. “Isotretinoin, depression and suicide: a review of the evidence.” Br J Gen Pract 2005; 55: 134-8.
Strauss JS, Krowchuk DP, Leyden JJ et al. “Guidelines of care for acne vulgaris management.” J Am Acad Dermatol 2007; 56: 651-63.
U.S. Food and Drug Administration (FDA), “The iPLEDGE Program Patient Introductory Brochure” (pdf), December 2007.
Wysowski DK, Beitz J. Methodological limitations of the study "Isotretinoin use and risk of depression, psychotic symptoms, suicide, and attempted suicide". Arch Dermatol 2001; 137: 1102-3.
Wysowski DK, Pitts M, Beitz J. “An analysis of reports of depression and suicide in patients treated with isotretinoin.” J Am Acad Dermatol 2001; 45: 515-9.
Taking isotretinoin during the coronavirus pandemic
Having trouble getting your acne medication?
The AADA is advocating to find a solution to help patients get the isotretinoin they need. Patients can help us by sharing their stories.
Share your storyTaking isotretinoin during the coronavirus pandemic
Telemedicine and regulation changes allow patients to continue taking isotretinoin during the coronavirus pandemic. If you’re taking this medication to treat acne, learn more about what you need to know.
Isotretinoin is the generic name for a medication used to treat severe acne. If you take this medication, you know that you must meet with your dermatologist every 30 days. During the coronavirus pandemic, you may be wondering how that’s going to work. Rest assured, you can still:
-
Meet with your dermatologist.
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Get a new prescription for isotretinoin every 30 days.
-
Have your dermatologist monitor you.
To help patients shelter in place, the U.S. Food and Drug Administration (FDA) issued new guidelines for patients taking isotretinoin.
Two isotretinoin guidelines have changed
To help reduce the spread of the coronavirus in your community, your dermatologist may ask you to make the following changes:
Schedule telemedicine appointments: During the coronavirus pandemic, your dermatologist may meet with you online instead of in-person. This means that you will use your smartphone or computer to meet with your dermatologist. This type of appointment is called a telemedicine appointment.
If your dermatologist uses telemedicine, someone at your dermatologist’s office will provide all the information you need for these appointments.
For more information about what to expect from a telemedicine appointment, visit What is Telemedicine?
Perform home pregnancy tests: If you are a female who can get pregnant, you still need a pregnancy test every 30 days. During the coronavirus pandemic, you may use a home pregnancy test.
You are responsible for buying the pregnancy test. If you prefer to stay home, you can buy a home pregnancy test online and have it delivered.
Before you meet with your dermatologist, you must take the pregnancy test. During your appointment, you’ll need to tell your dermatologist the following:
-
When you took the home pregnancy test
-
The result of the home pregnancy test
If you’re uncertain when to take this pregnancy test, contact your dermatologist’s office.
Isotretinoin guidelines that stay the same
To keep taking isotretinoin, you must continue to do the following:
-
Get a new prescription from your dermatologist every 30 days.
-
Use two forms of birth control (or not have sex) if you can get pregnant.
Dermatologists continue to help patients with pressing needs
The pandemic has brought many changes in our lives. During this time, it can be comforting to know that one thing remains the same. You can continue to rely on a dermatologist’s expertise to help with you safely take isotretinoin.
Related AAD resources
For more information about how to protect your health, visit the AAD Coronavirus Resource Center.
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Last updated: 12/15/21
All content solely developed by the American Academy of Dermatology
References:
Elminan M, Bird ST, Delaney JA et al. “Isotretinoin and Risk for Inflammatory Bowel Disease.” JAMA Dermatol. 2013 Feb 1;149(2):216-20.
Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.