The use of isotretinoin in low doses and unconventional treatment regimens in different types of acne: a literature review

Abstract

High effectiveness of isotretinoin treatment for severe types of acne resistant to antibiotics has been widely recognized. However, the recommended doses in conventional therapy, according to consensus of the Polish Dermatological Society, may cause serious adverse effects. Thus, research into less stressful, alternative treatment regimens with the use of low doses of isotretinoin has been carried out. The aim of the paper was to review the selected papers where authors present the results of their studies on different regimens with the use of isotretinoin in low doses in patients with acne, evaluate their efficacy, patient satisfaction, frequency of adverse effects, recurrences and also treatment costs.

Systematic review of low‐dose isotretinoin for treatment of acne vulgaris: Focus on indication, dosage, regimen, efficacy, safety, satisfaction, and follow up, based on clinical studies

“…Oral isotretinoin monotherapy is the most effective treatment for severe acne 12 . Isotretinoin (13‐cis retinoic acid), a derivative of retinol (vitamin A) 13 was introduced in the early 1980s and revolutionized acne treatment 14 . Initially, the use of isotretinoin was limited to more severe cases of nodulocystic acne, but in recent years the drug has been widely prescribed in mild cases of acne that do not respond to conventional treatments 14 .…”

Plane warts on the back of the hand successfully treated with oral isotretinoin

“…Isotretinoin is currently approved only in severe forms of acne. However, retinoids, both systemic and topical, are also used in other diseases, including psoriasis, lichen planus, pityriasis rubra pilaris, Darier’s disease, ichthyosis, solar keratosis, oral leucoplakia, Xeroderma pigmentosum, keratoacanthoma, spinocellular carcinoma, dermatological forms of T-cell lymphomas, lupus erythematosus, rosacea, and hidradenitis suppurativa [ 1 , 2 ].…”

The rates of major malformations after gestational exposure to isotretinoin: a systematic review and meta-analysis

“…There is some evidence that there is a lower occurrence of MM after exposure to lower dosages [ 7 , 8 ]. Importantly, the introduction of active pregnancy prevention programs for isotretinoin after 2005 probably resulted in lower rates of fetal exposure to the drug and higher rates of artificial abortion if exposure has occurred [ 9 – 11 ].…”