Nolla Health announced Monday that Utah has cleared its Nolla Derm app to write new acne prescriptions, and calls it the first AI in the country allowed to do that. Utah adults fill out a 10-to-15-minute questionnaire and scan their face. The AI then picks one of eight approved treatments you put on the skin, for $4.99 a month. It can't prescribe pills or Accutane. It sends severe cases and pregnant patients to a doctor. Utah's Office of Artificial Intelligence Policy approved the one-year pilot under a program that waives some state rules. For now, doctors still approve every prescription before it goes out. First the pilot has to run four weeks and treat 100 patients. Doctors also have to agree with the AI 95% of the time, with no serious problems. Then Utah can let the AI send prescriptions straight to pharmacies, and doctors would check them afterward.

The app reaches people who can't get a dermatologist

Nolla and Utah's AI office say the app reaches people who'd otherwise go without care. They say its limits keep it safe.

Few people with acne ever see a dermatologist. Nolla says about 100,000 Utahns have active acne and only about one in ten sees one. Utahns wait 61 days on average to see one. Eleven counties have no dermatologist at all. A visit can cost up to $300. "AI will matter most in healthcare when it helps people get care they otherwise would not receive," said Luis Wenus, Nolla's co-founder and CEO.

The app can only pick from a short list. "The AI can't improvise," said Dr. Zaid Fadul, Nolla's chief medical adviser. Nolla says doctors agree with the AI's choice in more than 96% of cases. That's the company's own number. Zach Boyd, who directs Utah's AI policy office, calls the pilot a "narrow exception" to the rule that only licensed clinicians can prescribe. Fadul says the real test is "whether someone other than the company can shut it off."

But doctors say AI shouldn't practice medicine on its own

AMA CEO John Whyte and Utah's own medical board say prescribing takes a doctor's judgment.

Prescribing takes a doctor's judgment. Dr. John Whyte, CEO of the American Medical Association, told Bloomberg that AI tools "shouldn't autonomously be trying to practice medicine." In June, the AMA voted to keep AI under doctors' oversight. "AI has enormous potential in healthcare, but it cannot replace physician judgment," Whyte said then.

Utah's medical board already fought the state over this. The state's first AI pilot, with a company called Doctronic, began in January. It uses a chatbot to renew existing prescriptions. At first, a doctor checked every refill. In April, 11 of the 14 members of the Utah Medical Licensing Board asked the state to suspend it. They said nobody had consulted them. They also said the pilot "potentially places Utah citizens at risk." "There is a reason prescription refills require physician authorization," they wrote. The state says it briefed the board in March, and it refused to suspend the pilot. It said the pilot was operating safely because a doctor still reviewed every refill. Boyd says Nolla talked to the board before it launched.

And acne is only the first step

UCSF's Robert Wachter says low-risk AI prescribing can be safe, but he expects the rules to keep loosening. Nolla already wants to treat other illnesses.

Each approval makes the next one easier. Dr. Robert Wachter, chair of medicine at UC San Francisco, wrote in January about the Doctronic refills. He said he'd "have no problem using this system to refill my Lipitor." He also warned that "it's only a matter of time before the bar is lowered." He wants guardrails built fast to separate "safe AI-enabled care from reckless self-diagnosis."

Nolla is already looking past acne. Fadul says the flu and simple urinary tract infections are "worth exploring." He expects AI to "manage a large part of routine human healthcare checks" within ten years. He says that won't include opioids, stimulants or benzodiazepines. Wenus wants an "all-in personal doctor in your family, driven by AI."

Where This Lands

Nolla and Utah's AI office say the app gets acne treatment to people who wait two months or never see a dermatologist. They say the short drug list and doctor audits keep it safe. The AMA says AI shouldn't make prescribing decisions on its own. Utah's medical board has already tried to stop the state's first AI prescribing pilot. Wachter says low-risk cases may be fine, but each one lowers the bar for the next. Doctors are approving every prescription for now. After four weeks and 100 patients, Utah can let the AI prescribe on its own. Doctors must agree with it 95% of the time, and nobody can have had a serious problem.

Sources