Hello. Thanks for writing to us at healthcaremagic Dermatologists all round the world have been using Isotretinoin for acne with consistently reproducible results. It can very well be combined with Oral antibiotics like Azithromycin in addition to topical treatment for acne. The most concerning issues about Isotretinoin is that it is teratogenic i.e it can adversely affect the fetus, therefore retinoids are best avoided altogether in females of reproductive age group Or can be given only if adequate contraception is assured. Apart from the adverse effect on pregnancy, Isotretinoin can be assumed to be fairly safe for treatment of acne. Minor reversible side effects like cheilitis, dry skin, increased hair shedding are common and usually the only side effects of Isotretinoin treatment. Other side effects like minor elevations of liver enzymes, elevations of serum triglycerides are reversible and usually don t warrant discontinuation of treatment. Nevertheless they should be monitored in patients on Isotretinoin treatment. Finally, there have been few reports of suicides in patients on Isotretinoin but that is because the patient were already suicidal because of severe acne or other psychological problems. On the contrary Isotretinoin improves the quality of life of acne patients. In my view Isotretinoin brings remarkable improvement in severe acne and is considered to be a magical treatment of acne. This is specially of benefit in acne patients who had lost all hope for an effective curative remedy for acne. Regards