Acne is an impacting disease, and it is essential to treat acne early and effectively to avoid scars and psychological sequelae. Several topical and three sets of systemic drugs are usually given in combination for inflammatory acne except when isotretinoin is prescribed.

To date, oral isotretinoin is the only drug that can cure or prolong remission of moderate to severe acne, when given as single therapy, improving skin appearance and quality of life.

Off-label, low daily doses variable duration of the treatment have been used, with few side effects, same efficacy, and better patient compliance. Everyday adverse events such as mucocoutaneous are dependent on dose and easily managed with early and adequate orientation and use of emollients. It works by inhibiting the activity of the sebaceous gland and also has anti-inflammatory and immunoregulatory activity.

Another advantage of isotretinoin is that there are no psychiatric contraindications for it. This is a significant benefit considering acne to be a trigger for depression during adolescence. Itis considered being the first-line treatment for moderate to severe inflammatory acne in the absence of any contraindications. It is also suggested that there are no other therapeutic alternatives other than tretinoin, even topical treatments combined with oral antibiotics, which can achieve the same results. Other treatments are widely known for acnes recurrence, prolonging the risk of scars, compromising skin appearance, and causing emotional distress in teenagers.

Resource: Bagatin E, Costa CS. The use of isotretinoin for acne-an an update on optimal dosing, surveillance, and adverse effects. Expert Review of Clinical Pharmacology. 2020; 13 (8). DoI: https://doi.org/10.1080/17512433.2020.1796637