Pros & Cons 1-2 : What is the optimal way of isotretinoin treatment in acne? : Long-term low dose isotretinoin treatment (Cons)

Oral isotretinoin is the most effective treatment for moderate to severe acne. Isotretinoin (13-cis retinoic acid), a derivative of retinol (vitamin A) was introduced in the early 1980s and revolutionized acne treatment. 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. Isotretinoin has many side effects, though most of them are predictable and rarely interfere with patient management. Common side effects are dose-dependent and can be tolerated by changing the dose or treating additional symptoms. The standard dose of isotretinoin is 0.5-1 mg/kg/day, but various regimens are used in real world practice. In cases where acne is less severe, this dose is relevantly high; therefore, low-dose regimen for mild to moderate acne can be used to reduce side effects and achieving a cost-effective treatment option. Recent studies support the effectiveness of long-term low dose isotretinoin treatment. In this session, I will share the updated evidence about long-term low dose isotretinoin among various isotretinoin treatment regimens.