Accutane (isotretinoin) is serious medicine for a serious problem. The people who benefit from Accutane have more severe or resistant forms of acne. Derived from Vitamin A, it works by stopping the production of sebum, an oily substance where bacteria thrive. Accutane is taken for five months and the results are routinely exceptional. Because of the cost and potential side effects, other medications are tried first.

Cost of Accutane

Accutane is very expensive. Health insurance and Medicaid will cover the cost, but often require documentation of previous medical attempts and a diagnosis of severe resistant acne. At MASC, patients who need Accutane are assisted through the coverage process.

Side Effects of Accutane

Everyone who takes Accutane will get very dry skin. This is expected and shows the medicine is working. Moisturizers and Chap-Stick alleviate this bothersome, but not serious effect. Besides dry skin, everyone taking Accutane is monitored for other rare side effects. Blood work is taken before and during treatment to assure the medicine is safe. Because Accutane temporarily increases the rate of birth defects, most female patients are required to have monthly pregnancy tests. Once Accutane is completed, the birth defect rate returns to normal.

Most people who take Accutane have a significantly improved self-image because their skin becomes clear. While some people have become depressed while taking Accutane, this is uncommon, and occurs no more frequently than people not taking Accutane. Recent studies investigating this issue confirm this finding. To be sure, each patient who gets Accutane through MASC is monitored closely. As a Board Certified Family Physician, Dr. Sulik is trained and experienced in the diagnosis, recognition, and treatment of depression. Click on the following handout-link for more details on this topic. Parent Handout

Recently, heavily advertised lawsuits raise the concern about Accutane and Crohn's disease. Crohn's is a serious autoimmune disease of the G.I. tract and results in patchy inflammation. Many people are diagnosed each year with Crohn's and the vast majority were never treated with Accutane. A recent study of 45,000 people support that Accutane does not cause Crohn’s. For more information on this topic, click on the following handout-link. Accutane and Crohn's


All prescriptions for Accutane must come from a certified prescriber, and everyone who takes Accutane is carefully monitored through an online service called iPledge. The pharmacy will not fill a prescription for Accutane unless all of the monthly iPledge requirements are complete. The main focus of iPledge is the prevention of pregnancies, but even male patients have specific monthly steps, and all patients receive an iPledge ID number and password. Female patients are required to show a monthly negative pregnancy test. The first prescription cannot be filled until two pregnancy tests are negative. Additionally, most female patients must pledge to two forms of contraception (typically oral birth control and a barrier form) or complete abstinence.

The iPledge system can be frustrating. If everything occurs on a timely basis, it typically flows without hassle. At MASC, every prescription for Accutane is treated very seriously. Each visit includes reviewing the iPledge requirements and even going online to complete all the loose ends!