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Medium dose isotretinoin for the treatment of acne
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.