A large part of my practice is treating patients with old acne scars. Many come in expecting the magic of lasers to erase their woes. Unfortunately, if the acne persists I am often very wary to convince patients into scar treatments. “You cant heal a bruise without first stopping the punch in the arm” is my lingo. It is imperative to stop acne that is scarring. Many of these patients have used every cream and antibiotic under the sun and have entered adulthood with an unrelenting problem. Contrary to the popular belief of Accutane being an evil and dangerous drug, it is still to this date the only possible cure for acne and certainly the only wonder drug in dermatology. Unfortunately, those that put down the drug don’t consider acne a real medical disease which requires real medicine. Like any drug such as anti-hypertensives, anti depressants, cholesterol lowering drugs amongst others, Accutane can and does have controllable side effects. What is different is that with Accutane you DON’T have to take it for the rest of your life like other drugs. For Most people 5 months of Accutane can effectively and dramatically reduce or cure acne for a decade or more. The main concern of the drug is its effect on the babies of pregnant women. The key is not to get pregnant on the drug. It does not affect fertility and most drugs for medical conditions cause birth defects as well. The problem is …is that Accutane is often given to women of child bearing age. As with any medicine it must be prescribed and taken responsibly. The other concern, which I have not seen much of in my 15 years of writing the drug, is the risk of exacerbating or causing depression. If it were the case, again, numerous drugs that are used every day for high blood pressure and anxiety carry the same risks. As with any drug, patients have to be monitored and doses adjusted so patients can tolerate the medicine. Fortunately, after a 5-6 month course of the drug all effects of the medicine resolve except the Acne. It is sad that this drug is becoming less and less available to thousands of patients that suffer from severe acne. I certainly plan to continue treating my more severe patients with this drug that I have had almost universal success with.