As a pediatric endocrinologist specializing in growth and bone development, I’ve seen firsthand how well-meaning treatments can unintentionally interfere with a child’s final height potential. One medication I’m increasingly concerned about is Accutane, also known by its generic name, isotretinoin.
Used widely for treating severe acne in adolescents, Accutane is powerful—and effective. But it’s not without risk. One lesser-known concern that’s gaining attention among pediatric specialists is its potential to stunt growth by prematurely closing growth plates.
If your child or teen is still growing and considering Accutane, here’s what you need to know before making that decision.
Accutane is a high-dose vitamin A derivative (retinoid) prescribed for nodular or cystic acne that doesn’t respond to standard treatments. It’s one of the most effective medications dermatologists have, and for many teens struggling with painful or scarring acne, it can be life-changing.
But while skin might be the focus, the skeletal system may pay the price—especially during puberty.
Your child’s height increases during puberty thanks to their growth plates—areas of cartilage at the ends of long bones that drive linear growth. These plates remain open during childhood and adolescence, then fuse (close) permanently after puberty, signaling the end of height growth.
Several studies and clinical reports suggest that isotretinoin may accelerate bone maturation or directly cause premature growth plate closure in pediatric patients. Once a growth plate closes, no further growth in that bone is possible.
In simpler terms:
Accutane may end a child’s growth window too soon—leading to shorter adult height than expected.
Not every teen on Accutane will experience stunted growth, but certain factors raise the risk:
Children under age 16 or teens with lots of growth left
Kids with delayed or borderline puberty
Teens not yet at genetic mid-parental height
Adolescents with underlying endocrine or bone density concerns
High-dose or long-term Accutane use
While large-scale clinical trials are limited, growing evidence and clinical experience point to potential risks:
Case reports link isotretinoin to early epiphyseal (growth plate) closure, especially in younger teens. Duvalyan et al. (2020), Pediatr Blood Cancer 67:e28236
Studies have shown altered bone metabolism, reduced bone mineral density, and skeletal hypermaturity in patients on long-term or high-dose Accutane. AIMS Bioengineering, 2024, 11(2): 212-240
Some data suggests retinoids may suppress growth hormone pathways—compounding the effect. Endocrines (2023) by Cardoso‑Demartini et al
In our practice, we’ve evaluated teens who experienced abrupt growth deceleration after starting Accutane, only to find their growth plates had closed prematurely.
If your teen is on or about to start isotretinoin, watch for:
Lack of height gain over 6–12 months
Sudden change in shoe size or growth patterns
Completion of puberty before expected
Fatigue or changes in physical development
Even better—don’t wait for signs. Be proactive.
If your child or teen is considering Accutane, request a pediatric endocrine evaluation first, especially if they are still in active growth. We work in close coordination with your child’s dermatologist and can perform a baseline bone age X-ray before starting Accutane, with scheduled follow-ups to monitor for any signs of accelerated growth plate closure.
We offer:
✅ Bone age X-rays to assess growth plate status
✅ Detailed review of puberty timing and growth velocity
✅ Hormonal labs, including IGF-1, thyroid, and vitamin D
✅ Individualized guidance on when it’s safe to start Accutane without sacrificing height
This is about protecting your child’s long-term growth potential while still supporting their self-esteem and skin health.
If your teen is still actively growing but has severe acne, consider:
Postponing Accutane until closer to the end of puberty
Exploring hormonal acne treatments, topical retinoids, or low dose systemic antibiotics
Using Accutane at a lower dose and for a shorter course
Co-managing with both a pediatric endocrinologist and a dermatologist for balanced care, including periodic bone age scans to track signs of accelerated growth plate closure.
I’m not against Accutane—it can be transformative. But we firmly promote informed, strategic timing when it comes to children and teens who are still growing.
Growth is a one-time opportunity. Once a growth plate closes, it never reopens.
At Life Pediatric Endocrinology, we help families across the country make smart, evidence-based decisions that protect their child’s future—including height, bone health, and overall well-being.
We serve families across Brentwood, Franklin, Cool Springs, and the Greater Nashville area— and from Atlanta, Buckhead and Sandy Springs—to Atherton, Beverly Hills, Los Angeles, and Newport Beach. We offer virtual consultations for teens throughout the Southeast and beyond.
📍 Schedule a growth evaluation today with Dr. Kelli Davis and the nationally recognized team at Life Pediatric Endocrinology.
Let’s make sure your child gets clear skin and a strong, healthy future.