Medium dose isotretinoin for the treatment of acne

Abstract Background Although the efficacy of isotretinoin in the treatment of acne is unquestioned, improvement of patient tolerance and acceptance of the drug are desirable. Furthermore, no data on acne-induced scarring during isotretinoin treatment are available. Aim In the present study, we have evaluated the efficacy and tolerability of an initial stepwise incremental ( n =83) or an initial high dose ( n =11) and a subsequent medium maintenance dosing of isotretinoin in outpatients treated for acne over a 7 year period. Methods Ninety-four patients with moderate to severe acne were treated for a mean duration of 8.3 months, at a mean daily dose of 31.4 mg. Follow-up and final evaluation were done during outpatient visits and with a standardized patient questionnaire. Results Response to treatment was very good in 62.8% and good in 31.9% of patients, with only one treatment failure. Of the patients, 21.3% required retreatment after a mean interval of 7.7 months. Four patients refused or dropped out from treatment, 27% noted initial mild worsening of their acne, and none experienced severe adverse effects. Scars were present in 89.4% of patients, with improvement occurring in 67.9% during treatment. Conclusion The altogether good to excellent clinical response of acne lesions and acne scars, with a low side effect profile, warrants further study of this simple, modified treatment regimen in patients with acne and acne-induced scarring.