This drug should only be prescribed by a dermatologist for severe acne. You will need regular blood tests. Most patients sail through and it is life changing but the issue for pilots is the risk of psychiatric disorders and suicide. This risk is inversely related to age and has been reported up to 35% at 10 years. There is a spectrum of severity so for other professions it may not be as significant but for pilots the risk (of losing your license) is much higher even though the hazard ( a psychiatric disorder) is the same