Demystifying Isotretinoin Prescriptions and Introducing the SkinSync Podcast

“I have been a dermatology PA for 23 years and have always prescribed isotretinoin and always will. It is absolutely a game-changing and life-changing medication for our patients with recalcitrant acne, or for scarring cystic acne,” said Shanna Miranti, MPAS, PA-C, in an interview at the 2025 Elevate-Derm Summer Conference.

Miranti, a board-certified physician assistant at Riverchase Dermatology in Naples, Florida, and a Dermatology Times editorial advisory board member, presented her tips for prescribing isotretinoin for patients as acne, as well as her involvement in the new SkinSync podcast with Elevate-Derm Alliance.

Miranti’s presentation, “Lessons Learned in Acne,” focused on the underutilization of isotretinoin due to iPLEDGE-related challenges and emphasized why PAs and NPs should feel empowered to prescribe it. She reaffirmed her support for isotretinoin in cases of recalcitrant or scarring cystic acne and shared concern that administrative hurdles have discouraged many clinicians from using a medication she describes as life-changing for patients. Her goal of the presentation was to demystify the prescribing process and offer actionable guidance to increase comfort and confidence with initiating and managing isotretinoin therapy.¹

Miranti also provided a deep dive into implementation strategies to simplify isotretinoin prescribing. Her tips included workflow optimizations such as establishing protocols with specialty pharmacies and structuring office schedules to ensure timely monthly follow-ups. She also presented her personal set of “Accutane hacks,” a collection of practical tips clinicians can apply immediately to minimize friction points in isotretinoin management. For Miranti, her points were designed to improve access for patients while maintaining clinic efficiency, ensuring that patients who need isotretinoin are not left untreated due to logistical barriers.

Beyond her lecture, Miranti shared her excitement about co-hosting SkinSync, the first podcast created by dermatology PAs and NPs for their peers, produced by Elevate-Derm Alliance.² The podcast aims to serve as a clinically relevant and relatable resource for PAs and NPs in dermatology. Additionally, reflecting on her experience at her first Elevate-Derm Summer Meeting, she praised the high-caliber education, noting the consistent value in each session and the opportunity to engage with dedicated and knowledgeable peers across the dermatology community.

References

1. Miranti S. Lessons learned in acne. Presented at: 2025 Elevate-Derm Summer Conference; July 24-28, 2025; Park City, UT.
2. Welcome to SkinSync: your dermatology update: Elevate-Derm Alliance. Accessed July 26, 2025. https://www.elevate-derm.com/skinsync-podcast