Millions Of Teens Take This Acne Pill. Some Say It Nearly Cost Them Their Lives — And No One Warned Them

“I’ve noticed my moods really change and I’ve had a lot of thoughts [of serious self harm],” one isotretinoin user wrote four months into treatment.

The drug was combating stubborn acne as it was supposed to: their skin had healed “a lot” and left them “so happy.” But that joy was offset by a surge of extremely dark ideas that left them hoping “to just hold on” and see out the treatment.

“I’m scared of my own thoughts and can’t help but think it’s related,” the user wrote in the r/Accutane subreddit – named after the discontinued brand that isotretinoin is most associated with.

The bleak ending of the post captures a trade-off widely described in online isotretinoin communities: months of harsh side effects in exchange for the chance of clear skin. It’s as if it’s left to teens to decide for themselves: what’s worse — the acne you’re getting bullied for, or the rap sheet of debilitating side effects the medicine brings?