Small molecule
PubChem CID 5282379
Isotretinoin
Accutane
- Mechanism of action
- Retinoid (precise mechanism not fully established)
- In plain language
- Shrinks and calms down the skin's oil glands so they stop producing the excess oil and clogged pores that drive severe acne.
- How it works
- Isotretinoin is an oral retinoid that, at pharmacologic doses, suppresses sebaceous gland activity and normalizes follicular keratinization; its precise molecular mechanism is not fully established. Effects are mediated in part through retinoic acid receptor and retinoid X receptor pathways that reduce sebaceous lipid synthesis, alongside receptor-independent induction of sebocyte apoptosis and reduced basal sebocyte proliferation, together shrinking sebaceous gland size. Clinical improvement in nodular acne correlates with a dose- and duration-dependent reduction in sebum secretion. A single 15-20 week course produces complete, prolonged remission in many patients, reflecting durable changes to gland size and differentiation rather than a simple reversible receptor blockade.
- Therapeutic applications
- Indicated for severe recalcitrant nodular acne, defined as multiple inflammatory nodules 5 mm or greater in diameter, in patients whose disease has failed to respond to conventional therapy, including systemic antibiotics. Indicated only in non-pregnant patients due to teratogenic risk.
- Class
- Small molecule
- Therapeutic area
- Dermatology
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