Isotretinoin is an exceedingly safe and effective therapy for acne and is currently FDA approved for severe recalcitrant nodular and cystic acne. In the opinion of the American Academy of Dermatology, as well as key opinion leaders in the field of acne and Isotretinoin, the drug also can be used for less severe cases of acne fail that more than 6 months of conventional anti-acne therapy; scarring acne of any type; and acne associated with significant psychological distress. The most important intervention in acne management is preventing scarring in the first place. All patients should consult a dermatologist to determine an individualized treatment plan for acne that will lead to the most successful result. The high negative publicity regarding Accutane is being driven by trial lawyers and not based on science.