Catalin Popescu, Associate Professor of Dermatology, Carol Davila University of Medicine, Bucharest, Romania
Isotretinoin has dramatically changed the lives of patients with nodulo-cystic acne. In low dose it is also very effective in less severe acne cases, in which other therapies have failed to achieve long-term remission. However, isotretinoin is frequently underutilised due to fears of rare but severe adverse effects such as depression, suicide and inflammatory bowel disease. Are these fears justified? What is the best available evidence regarding these risks? How should they be managed?