2023/2024 Isotretinoin Report & Study Findings Below If you want to skip the story and head straight to the TLDR

Just thought I'd chime in on my experience with prescription isotretinoin in the UK recently incase it's helpful to anyone who suffers with acne related to AAS (or otherwise) and is considering treatment, and the recent developments and research into isotretinoin which began in 2019 and ended April 2023.
Especially in the UK as it's a long and tedious process to get this medication, it's mandatory for you to be prescribed most if not all other options before they'll even consider you for isotretinoin treatment and you'll need to be signed off by two specialist doctors to access the medication.

A bit of context for my situation, I've suffered with acne since my early teens and heavily during my 14-16 years, I guess you could call it 'hereditary' acne as it's been common in the family I'm told, so I'm quite prone however now I'm 'getting on' in age I currently suffer only minor outbreaks occasionally.
During high-school I was prescribed isotretinoin capsules for my acne due to the severity, it was a blessing for me as I heavily suffered in my face and this medication COMPLETELY destroyed my acne, I must've tried 15+ other prescription creams, ointments, lotions, treatments etc and NONE made any difference to me besides isotretinoin.

I personally made it through without any harmful side effects or issues (to my knowledge), however was advised heavily at the time about the mental health toll this medication can cause on you. However at that time very minor to little information or warning was given about erectile dysfunction and the toll on your sexual health from this medication.

So fast forward to Feb 2024, I had a sudden major break out on my chest of cystic acne. My speculation of the reason 'why' is because I was trying out a new brand of AAS' which were heavily dosed during this period and I had unfortunately miscalculated, it's not my first rodeo with AAS and I'd like to think this mistake could happen to anyone in a lapse of concentration. (Oops)
I have isotretinoin from reputable sources on standby for this reason, however out of curiosity I went to the doctor anyway to see if anything had changed regarding treatment options.

Of course they prescribed me some cream, standard response, hasn't changed since my first experience with this in my teens... "Try this cream and if not we'll try a different one", rinse and repeat a few times.
However this time was different, this time the cream made the acne worse. To the point where my chest and back was chemically burned and my chest got infected as a result.
So I return to the doctor a little pissed off, as I physically could not get comfortable enough to sleep with the pain of these cysts and them bleeding and oozing brown infected shit all over my clothes and bed sheets.

The response; "We can't refer you to the dermatologist until you've tried these treatments for 4-5 months. Here is a course of antibiotics and some painkillers for the rest."
They wanted me to continue using the cream that burned my skin and caused me an infection, I was dumbfounded. I refused.
Instead I tried every trick in the book I knew to calm it down, antibiotics, tanning beds, supplements, reduced my dosages, changing sheets every few days, changing constantly. It worked, and the acne calmed down and returned to my 'normal' however with a few new scars to highlight my experience.

Fast forward again to April 2024, a letter comes out of nowhere saying I'd been referred to the dermatologist. I hadn't even gone back to the doctor or spoke to them after my last experience with them so it was a bit of a surprise that they'd referred me forward anyway. Again, curiosity takes over so I went ahead and attended the appointment.

Here is where things get interesting again.

At the appointment there is two specialist doctors, and one asks me what treatment I'd like. My response? Isotretinoin. It's the only treatment that's ever worked for my acne, so I thought I'd take the opportunity to get some prescription stuff while I have the chance.

She sees my scars and agrees with me, however responds with; "If you'd have come to me 2 months ago I'd have said yes and prescribed it for you immediately, however we've just had TWO new studies come forward and they're advising us to HALT all prescriptions of accutane (isotretinoin) in the UK for men.
So she palms me off with a long ass supply of some different antibiotics to take twice a day if I ever break out again and I'll see her again in 3-4 months.

TLDR; Dermatologist recently told me they've had two new studies published in the UK that are highlighting a VERY HIGH chance of ED/Sexual Disorders in males taking isotretinoin treatments and have been advised to HALT prescription of the drug for males until further studies are taken. Females are affected too but only during pregnancy.

I've been doing some research into these studies since and I think I've found them, they are certainly highlighting more the sexual health side effects of the drug as-well as the mental health side now. It's an interesting read, here are some of the highlights;

In 2019, the MHRA commissioned the CHM to undertake a review of the safety of isotretinoin following ongoing reports of suspected psychiatric and sexual side effects, to consider whether further regulatory action was required to minimise the risk to patients. In April 2023, the CHM’s Isotretinoin Expert Working Group (IEWG) published a report outlining the evidence reviewed and its key recommendations regarding isotretinoin. They realised that implementation of the recommendations would require substantial changes to current practice, therefore, they convened an Isotretinoin Implementation Advisory Expert Working Group (IIAEWG). The IIAEWG report was published in October 2023 and forms the basis of the new regulatory position.

Points within;

5.3.1. Age and gender
In 80% of the reports, the patient was identified as male and 19% as female. In the remainder the
gender was unknown. A valid age was provided for 160 of the 184 patients reporting sexual
dysfunction.

Table 3. Dose of isotretinoin provided by 73 of the 184 patients reporting sexual dysfunction
Daily dose
20mg or under (15)
21 – 40mg (33)
41 – 60mg (16)
61 – 80mg (9)

https://www.gov.uk/government/publications/report-of-the-commission-on-h...
Direct PDF: https://assets.publishing.service.gov.uk/media/6448cd0a529eda00123b047d/...

Thank you for reading if you even made it this far, I'm sure a lot of you are aware of this drug and the side effect and have positive experiences with it, mine are positive too, but it's always nice to stay informed.