Isotretinoin (Accutane)
Oral retinoid for severe acne. Highly effective, requires monthly monitoring + iPLEDGE.
20-week course for severe nodulocystic acne. ~80% remission rate. Requires monthly blood work (LFTs, lipids), iPLEDGE program enrollment, and strict pregnancy prevention. Most telehealth platforms have stopped offering isotretinoin post-2024 due to monitoring complexity.