A 28-year-old woman of childbearing age is using isotretinoin (a vitamin A derivative) for acne. Evaluate the most appropriate preconception recommendation given the pharmacology and storage properties of vitamin A compounds.

Continue isotretinoin but add dietary beta-carotene and start prenatal vitamins immediately because extra vitamin A will offset any teratogenicity of the drug.

Switch immediately to a high-dose retinol supplement (preformed vitamin A) while attempting conception because more vitamin A reduces acne and will improve pregnancy outcomes.

Stop all topical acne treatments but continue systemic isotretinoin at lower doses without contraception because topical and systemic exposures are equivalent and low dosing is safe for pregnancy planning.

Discontinue isotretinoin under physician supervision well before conception and use reliable contraception until cleared per medical guidance, because vitamin A derivatives are teratogenic and fat-soluble forms can persist and cause fetal toxicity.