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Barriers to Isotretinoin Access and Treatment Continuity in an Underserved Pediatric Population: A Cross-Sectional

Charles B Lau1, Laxmi Behara2, Susruthi Rajanala3

  • 1Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA.

Pediatric Dermatology
|March 26, 2026
PubMed

Insights

Isotretinoin effectively treats severe acne, but administrative hurdles like scheduling and pharmacy access create barriers for many pediatric patients. Despite these challenges, most patients still perceive their acne treatment as successful.

Area of Science:

  • Dermatology
  • Public Health
  • Health Services Research

Background:

  • Isotretinoin is a crucial treatment for severe acne.
  • Its administration involves significant logistical and regulatory requirements, including the iPLEDGE program.
  • These requirements can disproportionately affect patients with existing access barriers.

Purpose of the Study:

  • To assess the impact of administrative and regulatory barriers on isotretinoin treatment for pediatric acne patients.
  • To identify specific challenges faced by patients in an urban safety-net setting.
  • To evaluate the relationship between these barriers and treatment adherence or perceived success.

Main Methods:

  • A cross-sectional survey was administered to 42 pediatric patients at an urban safety-net hospital.
  • Patients had completed at least one month of isotretinoin treatment.
  • The survey assessed demographics, treatment experiences, and encountered barriers.

Main Results:

  • 64.3% of patients reported difficulties with appointments, pharmacy access, or finances.
  • 33.3% of patients experienced treatment gaps due to these barriers.
  • Despite challenges, 97.6% of patients felt their isotretinoin treatment was successful.

Conclusions:

  • Administrative and iPLEDGE-related requirements for isotretinoin can exacerbate existing access barriers for pediatric acne patients.
  • High perceived treatment success coexists with significant logistical challenges.
  • Strategies to mitigate administrative burdens are needed to improve equitable access to effective acne treatment.

Keywords:
acne vulgarishealth disparitiesiPLEDGEisotretinoinpediatric dermatologysafety‐net hospitalteledermatology

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