Medium dose isotretinoin for the treatment of acne

Abstract

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.

Low-dose isotretinoin in the treatment of acne vulgaris

“…Our results were found to be similar to those reported in the literature in patients with moderate acne using the classical dosage of 0.5 to 1.0 mg/kg per day. 4,5 Mandekou-Lefaki et al 4 achieved excellent results in 68% and fair to good results in 31.2% in a group of 32 patients who received low-dose isotretinoin, 0.15 to 0.4 mg/kg per day for a mean duration of 8 months; the mean total dosage was 78.9 mg/kg. Hermes, Praetel, and Henz 5 treated a group of 94 patients and administered isotretinoin in an initial dosage of 10 mg/d with a variable increase according to side effects, reaching a mean dosage of 0.43 mg/kg, and reported very good results in 62.8% and good results in 31.9% of the patients.…”

Prospective Study of Risk Factors of Relapse after Treatment of Acne with Oral Isotretinoin

“…This count of lesions allowed to define the kinetics of the evolution of lesions under treatment for patients who experienced a relapse after treatment termination compared to those who did not. In other studies published in the literature, the assessment of acne was thus far less precise, using the classification of Burke and Cunliffe [10, 11], the technique of Leeds [1, 8, 14] or subjective improvement scales [9, 15]. …”

Evaluation of Evidence for Acne Remission With Oral Isotretinoin Cumulative Dosing of 120-150 mg/kg

“…[18][19][20][21] Nine conducted pre-and posttreatment acne severity assessments using acne-grading scales to measure response to ISO treatment. 4,[21][22][23][24][25][26][27][28][29] Three used both methods, and all 3 considered inflammatory and noninflammatory lesions. [30][31][32] One did not specify the method used to assess improvement.…”

“…Specifically, clinical improvement was evaluated by a Likert-type satisfaction scale, 22 absence of or clearance of either just inflammatory lesions 4,17 or all acne lesions. 23 Five from the alternative dosing phase used temporal endpoints.…”

“…20,29,32 Dosing Regimens All 8 studies during the initial and extended duration phases used only continuous daily dosing regimens. 4,[15][16][17][18]22,23,30 Three of 12 studies in the alternative dosing phase investigated intermittent dosing schedules, 24,28,31 and the remainder used only continuous dosing. 11,[19][20][21][25][26][27]29,32 Two evaluated very low-dose regimen of 20 mg/d 27,28 and 1 evaluated high cumulative dosing of 220 mg/kg and greater.…”