Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 12 4 2024 12 31 244 249 EN Nsovo Mayimele Tshwane University of Technology 2024 06 04 2024 08 24 Isotretinoin is a potent retinoid drug that is primarily used for the treatment of severe acne. Because of this the drug has attracted attention and has the potential for abuse and misuse. This review manuscript aims to explore the dimensions of isotretinoin abuse in South Africa. Discussed herein are the epidemiological trends, underlying motivations and associated health risks of Isotretinoin. The sociocultural and economic factors that contribute to this abuse is explored. Furthermore, Isotretinoin is rather perceived as a cosmetic enhancement tool, while it has controlled its accessibility. Hence, the regulatory framework that governs the access to controlled substances such as isotretinoin in South Africa is analysed and the gaps and enforcement challenges that allow for the misuse are explored. Isotretinoin remains an valuable drug in the management of severe acne. However, its potential for abuse in South Africa requires a comprehensive approach involving healthcare professionals, policymakers, and the public to ensure safe and appropriate use through implementing innovative rational medicine use (RMU) interventions that aim to protect public health while ensuring access for those with sincere need. https://jpc.tums.ac.ir/index.php/jpc/article/view/640 https://jpc.tums.ac.ir/index.php/jpc/article/download/640/406