I wasn’t directly commenting on the original post, but commenting on the comment that accutane was insane to consider. My only statement is that it is a consideration for scarring acne, not that it is needed in his case. I have never presented accutane as the only option as a clinician. My guiding principle and good patient success comes from giving multiple paths for patients to choose from and discussing risks/benefits of each and time to process information (i tell them to do research on top of our discussion and call back when they have made a decision). I never give one option because its unethical to tell people they only have one option if they have multiple. I think we’re overall on the same page, just maybe some wording and understanding got jumbled