Teenage Girl With Acne

Dr. Joel Schlessinger answers important questions you may have about the acne medication, Accutane.

Question: When is the best time to consider Accutane if my child has acne?

Answer: Generally, I wait until most reasonable methods of treatment for acne have been exhausted before I broach the subject of Accutane usage. That time interval can be months or years but, if I see evidence of severe acne or scarring happening (especially if this is causing anguish on the part of the patient), I will speed up the process on occasion. Acne is reversible with most Accutane treatments, so it is important to use it when necessary.

Question: Is Accutane dangerous?

Answer: Yes and no. Every drug has its risks and benefits, but Accutane has some serious concerns due to birth defects in pregnant women (teratogenicity). This only happens if the pregnancy is exposed to Accutane and won’t affect women after Accutane is stopped, should they then become pregnant.

Here is what the Food and Drug Administration (FDA) has to say about the risks for pregnant women who are exposed to Accutane, along with the importance of avoiding pregnancy while taking the medication.

Other concerns, such as depression, suicide, inflammatory bowel conditions, dry skin, headaches and joint pains are of note but, in my practice, I have never seen a single case of suicide or attempted suicide.  This doesn’t mean that it isn’t possible, but it is a commonly stated side effect and one that the press, in general, seems to promote as ‘fact.’

Medline Plus, a service of the U.S. National Library of Medicine of the National Institutes of Health provides more information about side effects of Accutane.

Dr. Joel Schlessinger has prescribed Accutane to family members.

While I feel Accutane is an incredibly useful drug and have used it on family members, I don’t take the decision to use it lightly and always weigh the risks seriously. If patients have a history of depression, I insist on a psychiatric involvement prior to starting it.

What questions do you have about Accutane that I haven’t answered here?

Posted Monday, February 20th, 2012 at 7:26 pm
Filed Under Category: Acne Skin Care
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Responses to “Dr. Joel Schlessinger answers questions about the acne medicine, Accutane.”


Great questions and answers. Do you know if the depression has a long term affect?


Hi Sarah,
If depression occurs, there doesn’t seem to be a long term effect. The problem with trying to figure out this question is that when depression occurs is exactly at the same time of life that accutane is generally used. Additionally, it is nearly impossible to tell if the depression came from having severe acne or the drug that is used to treat severe acne.
It is well known that severe acne can lead to depression, so the ‘cure’ may be considered the ’cause’ of the depression. Studies have shown both that depression gets better and gets worse with Accutane, so this isn’t all that much of a help.
What I know is that generally speaking, I have many teenagers who start accutane while being depressed and and up less depressed because their skin is clear and they finally can date and have a social life without fear of that next blemish. I also know that if I have a teenager who starts to get depressed or suicidal while on Accutane, I take them off of it pronto! So far I haven’t had anyone who has continued with depression after Accutane and luckily, no suicides or attempts.
Good luck! Dr. Schlessinger

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