If you’re dealing with severe acne that hasn’t responded to creams or antibiotics, isotretinoin might be on the table. This oral retinoid can dramatically shrink oil glands, reduce breakouts, and often gives long-lasting results after a single course. But it’s powerful — so you should know what to expect and how to protect yourself while taking it.
Isotretinoin lowers sebum production, prevents clogged pores, and reduces inflammation. Doctors usually recommend it for nodulocystic or scarring acne, or acne that hasn’t improved with other therapies. Typical treatment lasts about 16–24 weeks. Doses vary by weight, often starting around 0.5 mg/kg/day and sometimes increasing toward 1 mg/kg/day. Many people reach a total cumulative dose linked to lower relapse (often around 120–150 mg/kg), but your prescriber will tailor this to your needs.
Expect a possible flare in the first few weeks — new pimples can appear before things get better. That’s normal but worth telling your doctor if it’s severe.
The most common issues are dry skin, chapped lips, dry eyes, and nosebleeds. Less common but important effects include raised cholesterol or triglycerides, and increased liver enzymes. For that reason, clinicians usually order baseline blood tests — lipids and liver function — and repeat them a few weeks into treatment.
Isotretinoin is highly teratogenic: it can cause serious birth defects. If you can become pregnant, you’ll need to follow strict pregnancy-prevention rules — reliable contraception, negative pregnancy tests before and during treatment, and close follow-up. Many countries run formal prevention programs (for example, iPLEDGE in the U.S.); Canada has similar safety measures. Don’t stop birth control without medical advice.
Mood changes and rare cases of severe depression have been reported. Watch your mental health and contact your prescriber right away if you notice new or worsening depression, thoughts of self-harm, or major mood swings.
Avoid vitamin A supplements while on isotretinoin — the combination can raise the risk of toxicity. Also avoid tetracycline antibiotics at the same time because of a small risk of increased brain pressure (intracranial hypertension).
Simple skincare helps: use a gentle cleanser, heavy lip balm, and daily sunscreen (skin becomes more sun-sensitive). Skip waxing or aggressive skin procedures during and for months after treatment unless your dermatologist approves.
Thinking about buying isotretinoin online? Get a prescription from a licensed clinician and use reputable pharmacies. Avoid sellers that promise no prescription, since counterfeit or improperly handled meds are risky.
Ask your prescriber what to expect, what labs you’ll need, and how long follow-up will last. With the right medical supervision, isotretinoin can be life-changing for stubborn acne — but safety checks and honest communication with your healthcare team are non-negotiable.
