For severe acne or moderate acne that does not respond to other therapy, the guidelines recommend oral isotretinoin. Because this medication carries a high risk of birth defects, females must take careful steps to prevent pregnancy while on isotretinoin, and all patients who take the drug must enroll in the federal iPledge program. While some studies have suggested a connection between oral isotretinoin and inflammatory bowel disease or depressive symptoms, the evidence is not conclusive, however, patients should be aware of these risks and carefully follow their doctors treatment advice.
