Did a popular acne treatment drive a teenager to murder?

A criminal case has put the drug, isotretinoin, in the spotlight.

The medication is best known by the brand name Roaccutane in Australia and Accutane in America. It is prescribed and used daily to treat severe cystic acne when common creams and antibiotics don’t work.

Connor Hilton was 17 when he shot two of his friends in the head, killing one of them, in Texas in 2023. He blamed the prescribed acne treatment for causing suicidal and homicidal thoughts.

A judge rejected Hilton’s defence, but agreed to consider it during sentencing. Hilton eventually took a plea deal and agreed to serving 50 years in prison.

Australian dermatologist Dr Leona Yip said the medication was very commonly prescribed to adolescents and that there was no need to panic.

“This is a time where they can be quite vulnerable and have high risk of mental health issues, so it’s important not to confuse timing with causation with the medicine,” she said.

“When, in fact, the medicine works really well, improves self confidence and studies show that when acne improves, mood also gets better.”

The nation’s drug regulator warns potential side effects can include depression, psychotic behaviour and, in rare cases, suicidal thoughts and actions.

Last April, the Therapeutic Goods Administration strengthened its safety warning, advising all patients have a mental health assessment before starting the medication.

Yip says violent behaviour is not an expected side effect and urges parents and teenagers who are looking at acne treatment to discuss the issues with their GP or dermatologist.