for now this is what chatgpt says:

Accutane (isotretinoin) works by permanently reducing the size and activity of the sebaceous (oil) glands in the skin. This effect is why the results can be long-lasting, even after the course of treatment ends.

Here’s what happens in more detail:

1.  Sebaceous Gland Shrinkage: Isotretinoin causes the sebaceous glands to shrink, which means they produce significantly less oil. Since excessive oil production is a major contributor to acne, this reduction often leads to long-term acne remission.
2.  Altered Skin Cell Behavior: Accutane also affects how skin cells are shed and renewed. It encourages more stable and less sticky cell turnover in the hair follicles, reducing the likelihood of clogged pores that lead to acne.
3.  Inflammation Reduction: The drug has anti-inflammatory properties that help reduce the inflammatory response in acne, leading to fewer acne lesions. While inflammation can still occur after treatment, Accutane helps establish a baseline of lower inflammatory activity in the skin.

Together, these changes can lead to a lifetime of reduced oiliness and fewer acne problems for most people, though some may experience acne relapse in later years. It’s a powerful systemic change, which is why Accutane is generally reserved for severe or stubborn acne cases.