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


  • If relapse after a 3/12 further Isotretinoin is required


  • 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’