Get an isotretinoin (Accutane) prescription online

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image of a white box labeled "Isotretinoin Rx only". In front of the box lies a silver blister pack containing ten oval-shaped capsules.

Medically reviewed by:
Dr. Ryan M. Trowbridge
Dermatologist

What is Accutane (isotretinoin)?

Accutane (isotretinoin) is the most effective FDA-approved option for treating severe acne, especially nodular or cystic acne that hasn’t improved with other therapies. Research shows it greatly reduces acne (in some cases eliminating it completely) in up to 85% of patients after just one course¹ ² ³.

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When is Accutane (isotretinoin) prescribed?

Isotretinoin (often referred to as Accutane) is only prescribed when strict safety guidelines are followed due to its potential risks. You may be a good candidate if you meet all of the following:

Your acne is severe enough to cause scarring
You’ve had persistent acne for several years
Your acne hasn’t responded to oral antibiotics, topical retinoids, or other standard treatments.

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Choose a dermatologist licensed in your state to request Accutane (isotretinoin) treatment

Dr. Ryan Trowbridge

Online Dermatologist

MD, MS, MA, FAAD

Medical licenses in the US:
Dr. Trowbridge is licensed in CA, CT, NE, IL.

Start a consultation

$59/mo*

*If you and your dermatologist agree that isotretinoin (Accutane) is appropriate for you, treatment will typically last 4–7 months. The monthly fee covers the dermatologist’s consultation fees. Medication, lab tests, and at-home pregnancy tests are not included. If isotretinoin isn’t suitable, your dermatologist may recommend an alternative prescription treatment.

Dr. Anna Chacon

Online Dermatologist

MD, FAAD

Medical licenses in the US:
Dr. Anna Chacon is licensed in 50 US states.

Start a consultation

$59/mo*

Medical requirements to start Accutane treatment

There are several important steps patients must follow before starting Accutane:

Requirements for everyone during Accutane (isotretinoin) treatment

Accutane can potentially cause some serious side effects, that is why patients should be carefully monitored by a dermatologist.

A new prescription is needed each month—refills aren’t automatic (as per the iPledge & FDA requirements).
Blood donation is not allowed during treatment and for 30 days after stopping, to prevent risk to pregnant recipients.
At least 2 blood tests typically (separated by about 2 months) are required to check liver function and triglyceride levels.
A monthly virtual evaluation is required before filling each prescription (as per the iPledge & FDA requirements).

Requirements for women during Accutane (isotretinoin) treatment

Accutane can cause serious birth defects, strict pregnancy prevention is required. Anyone who can become pregnant must:

Take a pregnancy test every month before getting a refill.
Use two forms of birth control at the same time, such as:
– One hormonal method (like the pill, patch, injection, implant, or IUD)
– One barrier method (like a condom with spermicide or a diaphragm)

How to get Accutane (isotretinoin) online?

Do you need a prescription to buy Accutane?
Yes, you definitely need a prescription to purchase Accutane or generic isotretinoin. To get a prescription, you need to have a virtual or in-person consultation with a licensed dermatologist in your state.

How to get an Accutane prescription online?

To get an online Accutane prescription or for generic isotretinoin, choose a dermatologist through Miiskin. If it’s medically appropriate for you, they will send a digital prescription to your preferred local or online pharmacy and you can then buy your isotretinoin (Accutane) right away at an affordable price.

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Mobile phone screen displaying a reviewed Accutane treatment plan from a dermatologist, including a prescription for 30 mg to treat severe acne, with pharmacy information shown below.

How to get an Accutane prescription via Miiskin

Select a dermatologist on this page to sign up.
Fill out the consultation form and take photos of your skin.
The dermatologist will evaluate your information and get back to you with recommendations and next steps (A video consultation may be required).
You may need blood tests and, if applicable, multiple pregnancy tests in a lab before starting treatment.
Once prescribed, you can buy your isotretinoin (Accutane) affordably from the pharmacy of your choice.

Start consultation

How to get a prescription for isotretinoin (Accutane) online?
Select one of the dermatologists on this page to start a consultation. Upon reviewing your submission, if the dermatologist determines that isotretinoin (Accutane) is safe and appropriate for you, they will explain to you the next steps necessary including necessary tests, side effects and more. A video consultation may be required.

How does Accutane work?

Clogged pores

✅ Yes

Normalizes keratinocyte differentiation, preventing comedone formation.

Increased sebum production

✅ Yes (main target)

Shrinks sebaceous glands by 70–90%, drastically reducing sebum production.

Cutibacterium acnes bacteria

✅ Yes

Indirectly reduces C. acnes by eliminating its lipid-rich environment (sebum).

Inflammatory mechanisms

✅ Yes

Lowers immune system overreaction, reducing inflammation in the skin.

Hormones

❌ No direct effect

Does not directly alter hormonal levels, but indirectly reduces acne by eliminating sebaceous gland activity.

Genetic & environmental influences

❌ No direct effect

Genetic predisposition remains, but long-term sebaceous gland suppression reduces relapse risk.

Benefits of Accutane (isotretinoin)

Highly effective

Up to 85% of patients achieve long-term results after 4 to 6 months⁴ ⁵.

Prevents scarring

By reducing severe breakouts, it helps prevent permanent acne scars.

Shrinks oil glands

Significantly reduces sebum production, making skin less oily.

Effective when other treatments don't work

Works when other treatments fail

Ideal for severe acne that hasn’t responded to other treatments⁶.

Reduces inflammation

Helps clear red, swollen, and painful acne lesions, improving skin texture.

May improve skin texture

Can make pores appear smaller and skin smoother over time.

Common Accutane (isotretinoin) dose

The Accutane dose prescribed depends on your weight, how severe your acne is, how well you handle the medication, and your treatment goals.

The American Academy of Dermatology (AAD) recommends starting with 0.5 to 1 mg per kg of body weight per day, usually split into two doses.

Some people may begin with lower doses to reduce the chance of potential side effects, while others might need higher doses to reach the recommended total.

The goal is typically a total dose of 120 to 150 mg per kg over the whole treatment, though higher doses may lower the chance of acne coming back. Your dermatologist will adjust your dose to find the right balance between results and side effects.

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Can you take a low dose of Accutane (isotretinoin)?

Although low doses of Accutane have been studied, there haven’t been enough large, high-quality trials, and the FDA hasn’t approved low-dose treatment plans.

Low-dose Accutane (about one-fifth to half the usual amount based on your weight) can reduce breakouts a lot, but the acne is more likely to return compared to standard doses.

Taking Accutane only part of the time (like 1 week each month) leads to more acne coming back (30–50% of cases). Taking it every day, even at a low dose, has a lower chance of relapse (10–30%), but adding antibiotics like azithromycin or clindamycin may help prevent this.

Relapse rates after low-dose isotretinoin therapy vary widely and can be as high as 39%, particularly with shorter durations or lower cumulative doses. While some studies report rates under 6%, these are often with extended treatment durations or shorter follow-up. On average, relapse rates tend to be higher than with conventional dosing unless cumulative targets are matched⁷ ⁸ ⁹ ¹⁰.

Reaching a higher total amount over time (over 120-150 mg per kg of body weight) is still the most effective way to keep acne from returning, but that’s harder to do with low-dose plans.

How to get an Accutane prescription via Miiskin

Select a dermatologist on this page to sign up.
Fill out the consultation form and take photos of your skin.
The dermatologist will evaluate your information and get back to you with recommendations and next steps (A video consultation may be required)
You may need blood tests and, if applicable, multiple pregnancy tests in a lab before starting treatment
Once prescribed, you can buy your isotretinoin (Accutane) affordably from the pharmacy of your choice.

Start consultation

How to get a prescription for Accutane online?
Select one of the dermatologists on this page to start a consultation. Upon reviewing your submission, if the dermatologist determines that isotretinoin (Accutane) is safe and appropriate for you, they will explain to you the next steps necessary including necessary tests, side effects and more. A video consultation may be required.

What patients say about Miiskin

Very happy with this service. Quick and easy. With someone with not the greatest insurance and super busy. This was perfect. Got my prescription next day and great advice for my condition.

Marcus Liniarski,
Patient Review →

I had a great experience with Miiskin – I was able to get my prescription very quickly and their app is easy to use. It was very convenient and their team is very responsive. I highly recommend them and will likely use them in the future for other skin issues.

Susie Tse,
Patient Review →

What a technology! I was very impressed by the speed of communication with a doctor using the Miiskin app. Losing my hair has been my biggest concern, but I didn’t have the courage to reveal my bald spot to a doctor in person. Miiskin solved all my issues instantly. I just took a photo in my own room, uploaded it, and wrote about my concerns. That’s it. The best part is that without insurance, the consultation fee was much lower than any health insurance. I submitted my photo at midnight and received a prescription the very next morning. The doctor at Miiskin was very professional and empathetic, which really helped ease my emotional distress. Although I’m just at the beginning stage of my treatment and haven’t seen significant results yet, I feel reassured and supported. I will definitely upload my progress in 3 to 4 months to show my appreciation for the prescription from Miiskin.

Jiyeon Kang,
Patient Review →

My dermatologist was extremely quick, reviewed my consultation request within 2hrs and I had my Rx the next day! The Miiskin team also responds within minutes and are very polite and communicated concisely. I’ll never make a in person appointment again after experiencing this outstanding and affordable telehealth service!

Dion H,
Patient Review →

Quick response from the dermatologist — I wanted a fast turnaround for a skin concern that would be more immediate than going through health insurance, making an appointment, traveling to the doctor.

Timothy C.
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Warnings, Side Effects and Purging

Precautions when taking Accutane (isotretinoin)

There are several important precautions to follow when taking Accutane. It’s highly teratogenic, meaning it can cause serious birth defects if taken during pregnancy, so strict birth control is required, and pregnancy termination is often recommended if exposure occurs. It should also be avoided while breastfeeding.

Some patients may experience mood changes like depression or anxiety, so mental health should be closely monitored. The medication increases sun sensitivity, so wear SPF 50 sunscreen and protective clothing. Avoid donating blood during treatment and for one month after stopping to prevent risk to pregnant recipients. Also, it’s best to skip alcohol to reduce stress on the liver and avoid raising cholesterol.

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Side effects of Accutane (isotretinoin)

Highly teratogenic (causes severe birth defects if taken while pregnant)¹¹ ¹²
Dry skin
Muscle or joint aches
Headaches
Abnormal menstrual bleeding
In very few cases it may cause depression and suicide risk, but it is highly unlikely¹³
May cause inflammatory bowel disease¹⁴ ¹⁵ ¹⁶

What is the Accutane (isotretinoin) purge?

Precautions when taking Accutane (isotretinoin)

The Accutane “purge” refers to a documented but short-term worsening of acne that occurs in some patients shortly after beginning Accutane treatment, with about 10–20% experiencing mild flares and fewer than 5% experiencing severe ones.

Studies confirm the phenomenon, especially in patients with numerous comedones, nodules, severe acne, or who start on higher doses, with young males being particularly at risk.

Expert guidelines (AAD, EADV, NICE) recommend strategies like starting with a low dose or using short-term corticosteroids to minimize flare-ups, and stress that flares usually resolve within a few weeks. Mechanistically, the purge is believed to stem from isotretinoin’s intense early effects on sebaceous glands and inflammation, not a true “cleansing” of hidden acne. Clinically, the purge is manageable in most cases, and dermatologists emphasize patient education and individualized treatment to maintain adherence and achieve long-term acne clearance.

Medications to avoid while taking Accutane (isotretinoin)

Other retinoids (tretinoin, tazarotene, adapalene, retinol)

Alpha and Beta hydroxy acids

Vitamin A supplements and retinoid products (risk of toxicity).

Tetracycline antibiotics (e.g., doxycycline, tetracycline) due to the risk of increased brain pressure.

St. John’s Wort, which can interfere with birth control effectiveness.

Progestin-only birth control pills, as they may be less effective while on Accutane.

Other things to avoid while taking Accutane (isotretinoin)

Getting pregnant (if female) or getting your partner pregnant (if male)
Alcohol
Medications that can irritate your liver like tylenol
Foods high in vitamin A (e.g., fish, dark leafy greens, carrots)
Prolonged sun exposure
Tanning beds
Cosmetic skin procedures (e.g., waxing, laser treatments, chemical peels) due to the risk of skin irritation and scarring.
Blood donation

Choose a dermatologist licensed in your state to request Accutane treatment

Dr. Ryan Trowbridge

Online Dermatologist

MD, MS, MA, FAAD

Medical licenses in the US:
Dr. Trowbridge is licensed in CA, CT, NE, IL.

Start a consultation

$59/mo*

Dr. Anna Chacon

Online Dermatologist

MD, FAAD

Medical licenses in the US:
Dr. Anna Chacon is licensed in 50 US states.

Start a consultation

$59/mo*

Provider & Prescription Information

Miiskin connects patients with independent dermatologists who provide care through their own private practices. Miiskin does not employ dermatologists and does not sell or distribute medications. Any prescriptions issued by the dermatologists can be filled at third-party pharmacies of the patient’s choice.

Got more questions about getting an Accutane prescription?

Is Accutane (isotretinoin) available over the counter?

No, Accutane (or generic isotretinoin) cannot be bought over-the-counter. It is only used for severe, nodular or cystic acne, therefore you need a doctor’s prescription and you can only use it with close medical supervision.

How much does it cost to get a prescription for Accutane?

Isotretinoin (commonly known by the brand name Accutane) must be taken under the close supervision of a specialized healthcare provider, such as a dermatologist. Ongoing monitoring, regular follow-up consultations, and lab tests are required before each refill. As a result, a monthly subscription payment is necessary for the duration of treatment.

How long does an Accutane prescription last?

Since Accutane requires the close monitoring of a dermatologist, you need monthly check-ups to get it renewed. Besides you need to use two birth control methods and take monthly pregnancy tests to avoid getting pregnant (if you are a woman) as it is highly teratogenic.

How/when will I get my Accutane?

Once you’ve completed the necessary tests and, if needed, a video consultation, and it’s confirmed that isotretinoin (Accutane) is appropriate for you, the dermatologist will issue a prescription to the pharmacy of your choice. They may also be able to recommend a pharmacy that offers isotretinoin at a more affordable price.

How do I start a consultation with a board-certified dermatologist to get Accutane prescribed?

Choose one of the independent dermatologists listed on this page and ensure the dermatologist is licensed to practice in your state. Once you’ve chosen your dermatologist, you can sign up and begin the consultation process immediately.

How long does is take to get Accutane (or isotretinoin generic)?

On average, it takes less than five minutes to complete your initial consultation request for Accutane. A dermatologist will typically review your information within two business days. If they determine that isotretinoin (Accutane) may be appropriate for you, it usually takes between one week and one month to complete the required tests before a prescription can be issued.

What is Miiskin?

Miiskin is a platform that connects patients with independent online dermatologists for convenient quality medical care for skin health issues.

References:
¹https://pmc.ncbi.nlm.nih.gov/articles/PMC10365865/
²https://pubmed.ncbi.nlm.nih.gov/23013115/
³https://pmc.ncbi.nlm.nih.gov/articles/PMC2835909/
⁴https://pubmed.ncbi.nlm.nih.gov/23013115/
⁵https://www.ncbi.nlm.nih.gov/books/NBK525949/
⁶https://pubmed.ncbi.nlm.nih.gov/16546586/
⁷https://pubmed.ncbi.nlm.nih.gov/21114478/
⁸https://pubmed.ncbi.nlm.nih.gov/24891681/
⁹https://pubmed.ncbi.nlm.nih.gov/30745980/
¹⁰https://pubmed.ncbi.nlm.nih.gov/30745980/
¹¹https://www.sciencedirect.com/science/article/abs/pii/S0301211523007856
¹²https://www.ogscience.org/upload/pdf/ogs-20373.pdf
¹³https://pubmed.ncbi.nlm.nih.gov/28291553/
¹⁴https://www.ncbi.nlm.nih.gov/books/NBK525949/
¹⁵https://pubmed.ncbi.nlm.nih.gov/36529376/
¹⁶https://pubmed.ncbi.nlm.nih.gov/36682724/