Isotretinoin

Key points

• Isotretinoin: oral retinoid (13-cis-retinoic acid) for severe acne — ↓ sebum production and sebaceous gland size; two-thirds get long-term remission/cure.
• HIGHLY teratogenic: two forms of contraception, negative pre-treatment pregnancy test, contraception 1 month before to 1 month after treatment.
• Most common side effect: dry skin, eyes and lips; also nose bleeds, hair thinning, photosensitivity, raised triglycerides, depression.
• Benign intracranial hypertension risk — do NOT combine with tetracyclines.
• Reduces plasma carbamazepine concentration.

Decision points in this pathway

• Female patient?

The full step-by-step algorithm, including what to do at each branch, opens in the app for approved members.