Can you buy Accutane over the counter (OTC)?

Table of Content:
What is Accutane? | Can you buy it OTC? | How to get Accutane? | Can I buy it online? | Lab tests | Can I work out? | Does it affect fertility long-term? | Does it have any interactions with other medicines?

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What is Accutane (isotretinoin)?

Dr. Eric Howell, a board-certified dermatologist says that Accutane (isotretinoin) is a life-changing medication for people with severe, scarring acne—particularly nodular or cystic acne that hasn’t responded to other treatment options such as antibiotics, retinoids, or hormonal treatment¹.

Can you get Accutane over the counter (OTC)?

Dr. Howell, says that you cannot buy Accutane (isotretinoin) over-the-counter (OTC) as it requires careful monitoring by a dermatologist. Patients must adhere to the iPLEDGE program (to prevent pregnancy-related birth defects)², undergo regular blood tests to monitor liver function and cholesterol levels, and manage potential side effects like dry skin, joint pain, and sun sensitivity.

So how can I get Accutane?

Dr. Howell says that to get Accutane (isotretinoin), you can have a consultation with a board-certified dermatologist for a full evaluation. The medication is only prescribed for severe, resistant acne, so your provider will likely try other treatments first unless your acne is causing scarring or significant emotional distress. Once Accutane is recommended, you’ll need to complete blood work and enroll in the FDA-mandated iPLEDGE program, which includes strict rules around pregnancy prevention for those who can become pregnant. After all requirements are met, your dermatologist can provide a prescription, but you’ll need monthly follow-ups, lab work, and in some cases, pregnancy tests before each refill is issued.

Can I buy Accutane online?

If you already have a valid prescription for Accutane (isotretinoin) from a licensed dermatologist and are enrolled in the iPLEDGE program, you can fill your prescription through a certified online pharmacy. 

Many major pharmacy chains and mail-order pharmacies allow you to manage your refills online, as long as all monthly requirements—such as lab results, pregnancy tests (if applicable), and iPLEDGE confirmations—are completed. Your dermatologist will electronically submit your prescription, and once the pharmacy confirms your eligibility in the iPLEDGE system, they can ship the medication to you. Just be sure to use a reputable, U.S.-based pharmacy that participates in the iPLEDGE program to ensure your treatment stays safe and legally compliant.

What lab tests do I need before and during Accutane treatment?

Dr. Howell says that before starting isotretinoin, your dermatologist will typically order baseline blood tests, including liver function tests, cholesterol and triglyceride levels, and a complete blood count. If you can become pregnant, a pregnancy test is also required. These labs are sometimes repeated during treatment to monitor for changes that could signal liver stress or elevated lipid levels, which are known side effects of the medication.

Can Accutane cause depression or mood changes?

Dr. Howell says that the reports linking isotretinoin to depression, mood swings, remain inconclusive and continue to be debated³. Because of this, your dermatologist will ask about your mental health history and check in regularly during treatment. If you notice any changes in mood, energy levels, or emotional well-being, it’s important to speak up right away. The priority is your overall health, and your provider may adjust the treatment or recommend supportive care if needed.

Is it okay to exercise while taking isotretinoin?

Dr. Howell says you can continue exercising while on Accutane (isotretinoin), but some people experience muscle or joint pain, especially with high-impact or intense workouts. If you notice soreness or stiffness that doesn’t resolve quickly, you may need to modify your routine. Staying well-hydrated, stretching, and allowing for adequate recovery can help, but always let your dermatologist know if the discomfort becomes persistent or affects your daily activity.

Will Accutane affect fertility?

Dr. Howell says that there is no evidence that Accutane (isotretinoin) affects long-term fertility. However, because it’s extremely teratogenic (meaning it can cause serious birth defects), it’s essential to avoid pregnancy during treatment and for at least 30 days after stopping. Once the medication is out of your system, it’s safe to conceive. This is why pregnancy prevention measures are so strict while you’re on the drug, but rest assured, your fertility itself is not permanently impacted by taking isotretinoin.

Can I get waxed or have cosmetic treatments while on isotretinoin?

Dr. Howell says you should avoid waxing, chemical peels, laser treatments, or any aggressive cosmetic procedures while on isotretinoin and for several months afterward. The medication thins and sensitizes your skin, making it more prone to tearing, scarring, and irritation. Even after finishing treatment, your skin may remain fragile, so always check with your dermatologist before scheduling any cosmetic work.

How do I manage severe skin dryness or irritation during treatment?

Dr. Howell says that dry skin and lips are among the most common side effects of isotretinoin, but they can usually be managed with the right skincare routine. Use a gentle, fragrance-free cleanser, a thick non-comedogenic moisturizer, and a healing lip balm throughout the day. Consider applying a hydrating facial cream at night and using a humidifier if your home is dry. Avoid products with alcohol, salicylic acid, or exfoliants, which can worsen dryness or irritation.

Can I travel while taking isotretinoin?

Dr. Howell says that you can travel while on Accutane, but it takes a bit of planning. Since prescriptions must be renewed monthly and may require lab and/or pregnancy tests you’ll need to coordinate with your dermatologist before traveling. Make sure you have enough medication for the duration of your trip, access to a local lab if needed, and a way to stay compliant with iPLEDGE. Also remember to use sunscreen SPF 50, a sunhat, protective clothing and sunglasses when being outdoors for extended periods. 

How does Accutane interact with other medications I’m taking?

Dr. Howell says that Accutane can interact with several medications, so it’s important to give your dermatologist a complete list of everything you’re taking, including supplements. Certain antibiotics, like tetracyclines, should be avoided due to the risk of increased intracranial pressure. Vitamin A supplements should also be stopped to avoid toxicity. If you’re on hormonal birth control, your provider will help ensure it’s compatible with iPLEDGE requirements. Always consult your doctor before starting anything new while on Accutane.

What should I do if I experience a serious side effect?

Dr. Howell says that if you experience a serious side effect like severe headaches, vision changes, intense mood shifts, signs of liver trouble (such as yellowing of the skin or eyes), or worsening depression, contact your dermatologist immediately. These symptoms may signal that the medication needs to be adjusted or stopped. Never ignore side effects that feel alarming or unusual—your dermatologist can help you decide whether it’s something manageable or a sign to pause treatment.

Why can’t I donate blood while on isotretinoin?

Dr. Howell says that the reason why blood donation is not allowed while you’re taking isotretinoin and for at least 30 days after stopping the medication is to prevent the possibility of Accutane being transferred to a pregnant person through a blood transfusion, which could cause serious birth defects. Even though you may feel fine, your blood could pose a risk to others during this time. Always wait the full 30 days after treatment ends before donating again.

Article References:
https://www.ncbi.nlm.nih.gov/books/NBK525949/
https://ipledgeprogram.com/#Main
https://pubmed.ncbi.nlm.nih.gov/28291553/

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