All About Isotretinoin

Treating Acne with Isotretinoin (Amnesteem, Claravis, Sotret)

Are you thinking about isotretinoin treatment for your acne? Before you jump into treatment, get a good understanding of how isotretinoin works, its possible side effects, and iPledge requirements for isotreintoin use.

Teenage boy (13-15) applying cream to acne, close-up
Isotretinoin for Acne. Bruce Ayres / Getty Images

Isotretinoin is a powerful medication used to treat severe acne. It is an oral medication that is taken once or twice daily. Isotretinoin may be best known under the now defunct brand name Accutane, but is also sold as Claravis, Sotret and Amnesteem.

Isotretinoin works by shrinking the oil, or sebaceous, glands in the skin. By controlling the oil, breakouts are also controlled. Unlike most acne medications, you don't have to continuously use isotretinoin to keep breakouts at bay. Most people only need one (16 to 20 week) course of treatment to get good results. After treatment is finished, pimples rarely come back.


Isotretinoin first made its mark in 1982, sold under the brand name Accutane.  In June 2009, however, Roche Holding AG decided to stop making this popular acne medication.  The drugmaker wasn't making enough money from the sale of the drug to justify continued distribution.

Isotretinoin continues to be sold under other brand names, so cystic acne sufferers can still get this medication if needed.

Accutane Alternatives


What Are the Side Effects?

Isotretinoin can be a great treatment for severe acne but, like all medications, it can cause side effects. These can include:

  • Dryness of the skin and mucous membranes
  • Fatigue
  • Thinning hair
  • Nausea and vomiting
  • Photosensitivity
  • Miscarriage and birth defects (in children whose mothers took the drug while pregnant)
  • High blood triglycerides

Your doctor will discuss the possible side effects with you before you start treatment. Remember, if you have any questions don't be afraid to ask.

There have been reports of depression, psychosis, suicide attempts, and suicide, in people taking isotretinoin. Exactly how or why this happens isn't known, but some researchers believe the drug may disrupt the way serotonin is made and used by the body.

Don't let this possible side effect scare you too much. Most people who take isotretinoin never experience any psychiatric problems and some research in dermatology has questioned if there's really any link at all. Just as a precaution, though, make sure you tell your doctor if you have a history of depression or mental illness. Know the warning signs and tell your doctor immediately if you experience any symptoms of depression, psychosis, or if you are having suicidal thoughts.


Prepare to become very familiar with iPledge. Anyone taking isotretinoin is required to be enrolled in this program. The primary goal of iPledge is to ensure no woman takes isotretinoin while pregnant, or becomes pregnant during treatment. Doctors who prescribe isotretinoin and pharmacists who dispense it must also register with the program.

Before receiving your first prescription, and for each month during treatment, you will have certain requirements that must be met. This can include monthly pregnancy tests, using two forms of birth control, and picking up your prescription within a certain window of time.

iPledge Requirements for Women of Childbearing Potential

iPledge Requirements for Men and Women of Non-Childbearing Potential


Should I Take Isotretinoin?

Isotretinoin is meant to be taken only by those with severe acne. If you have mild to moderate acne, try other acne medications first before jumping straight in with isotretinoin treatment.

Of course, not everyone is a candidate for isotretinoin treatment. But if you have already tried other acne treatments without much success, if your acne is quite severe, or if you have widespread acne of the back or body, isotretinoin may be an option. Your doctor is your best resource, so ask for his/her opinion. Even if isotretinoin isn't the treatment for you, your doctor will have other treatment options available so it's worth making that appointment.

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