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.


OBJECTIVE
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.


CONCLUSIONS
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.
Hermes
B
B
Department of Dermatology, Charité-Virchow Clinic, Humboldt University, Berlin, Germany.
Praetel
C
C
Henz
B M
BM
D000152:Acne Vulgaris / Q000188:drug therapy*; D000293:Adolescent; D000328:Adult; D002648:Child; D004305:Dose-Response Relationship, Drug; D005148:Facial Dermatoses / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015474:Isotretinoin / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D007641:Keratolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000139:chemically induced; D010146:Pain / Q000139:chemically induced; D010349:Patient Compliance; D017060:Patient Satisfaction; D012008:Recurrence; D012867:Skin / Q000187:drug effects / Q000473:pathology; D016896:Treatment Outcome
D007641:Keratolytic Agents; D008055:Lipids; D015474:Isotretinoin