Underserved Teens Face Barriers to Accessing Isotretinoin

Survey finds administrative, pharmacy, and financial hurdles disrupt treatment for many patients

Apr. 6, 2026 at 7:58am

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A cross-sectional survey of 42 underserved pediatric patients found that most reported experiencing at least one barrier to accessing isotretinoin treatment, including appointment difficulties, pharmacy-related issues, and financial challenges. Despite these obstacles, nearly all patients perceived the treatment as successful.

Why it matters

Isotretinoin is a highly effective medication for severe acne, but the study highlights how administrative requirements like the iPLEDGE program can magnify existing healthcare access barriers for underserved populations, leading to treatment gaps and disruptions.

The details

The survey, conducted at Boston Medical Center's Pediatric Dermatology Clinic, included patients aged 14 and older who had completed at least one month of isotretinoin treatment. Participants were predominantly from underserved backgrounds, with 76.2% publicly insured and 7.1% uninsured. Overall, 64.3% reported at least one access barrier, including appointment difficulties (35.7%), pharmacy-related issues (31.0%), and financial challenges. Treatment gaps occurred in 33.3% of patients, often due to scheduling conflicts, missed appointments, adverse effects, transportation issues, and iPLEDGE-related requirements. Despite these obstacles, 97.6% of patients perceived the isotretinoin treatment as successful.

  • The survey was conducted from June 2023 to April 2025.

The players

Charles B. Lau

The lead author of the study, from the Boston University School of Medicine.

Boston Medical Center

An urban safety-net hospital where the survey was conducted.

iPLEDGE

The federally mandated Risk Evaluation and Mitigation Strategy for isotretinoin, which requires monthly monitoring.

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What they’re saying

“These findings 'offer insight into the isotretinoin treatment experiences of a diverse, underserved pediatric population,' the authors wrote, adding that 'iPLEDGE requirements may magnify access barriers by adding requirements that interact with existing challenges in scheduling, transportation, pharmacy access, and health literacy.'”

— Charles B. Lau, Lead author

The takeaway

This study highlights the significant barriers that underserved teens face in accessing a highly effective acne treatment, underscoring the need to address systemic healthcare inequities and streamline administrative requirements that can disproportionately impact vulnerable populations.