Exact mechanism of action of Isotretinoin is not known but studies shows that it induces sebaceous gland apoptosis (cell death). One study suggests the drug amplifies production of neutrophil gelatinase-associated lipocalin (NGAL) in the skin, which has been shown to reduce sebum production by inducing apoptosis in sebaceous gland cells, while exhibiting an antimicrobial effect on Propionibacterium acnes.