The internet can make isotretinoin (Accutane) sound like a horror story, but the science and our day-to-day dermatology experience tell a very different story. We sit down with board-certified dermatologist Dr. Josh Grosshandler to unpack why this medication has stayed under the microscope for 40+ years and still stands as one of the most disease-changing tools we have for acne.
We start with the basics: what isotretinoin is, how an oral retinoid works, and why the sebaceous (oil) gland sits at the center of acne, inflammation, and scarring. From there, we get practical about who should consider Accutane today, including patients who are not “the worst of the worst” but are developing scars, feeling burned out on long routines, or carrying a heavy mental load from persistent breakouts.
Then we take on the myths head-on: Will acne purge before it clears? Does it work for hormonal acne? Can it shrink your nose? Is it truly a last resort or just a band-aid? We also tackle the biggest fear-based claims we hear online, including depression and suicide risk, infertility, permanent liver damage, and inflammatory bowel disease, plus what monitoring actually looks like in real care. You’ll also learn why absorption and taking isotretinoin with dietary fat can matter, and how simple supports like omega-3s may help with dryness.
If you’ve been scared off by viral posts, we made this for you. Subscribe, share with a friend who’s stuck in the acne cycle, and leave a review if it helps. What Accutane question do you want us to answer next?
DISCLAIMER: The views and opinions expressed in the Derm-it Trotter! podcast are those of the host and guests and do not necessarily reflect the views or positions of the guests’ or host’s institution or employers. The Derm-it Trotter! Podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user’s own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.
