Short and Long-term
- Dose dependent (120 mg/kg total dose in the minimum)
- 40% respond to initial therapy and do not require further treatment (Clin Exp Dermatol 1994;19:303-8)
- 20% of teens need further course of Isotretinoin
- 20% keep control with topical therapy only
- This response rate is lower in women with adult onset acne
Relapse
- If relapse after a 3/12 further Isotretinoin is required
Retreatment
- Wait a few months before another course of Isotretinoin as the acne may occasionally clear permanently even if new lesions appear for weeks after discontinuing the course.
- A relapse is defined as acne of similar severity as prior to therapy. In reality patients will have a lower tolerance to acne and want to retreat at lower grades of acne. Ongoing acne puts the patient at further risk of scarring.
Experts Opinion:
- Topical retinoids should be prescribed following therapy with Isotretionin
- inhibit recurrence of acne
- encouraging collagen production to fill in scars
- assist in clearing of post inflammatory hyperpigmentation
- Oral contraceprive pill
- Continuing with an OCP such as Diane35, Tricyclen or Alesse may reduce recurrence of acne especially in the adult ‘onset group’
