Higher Doses of Isotretinoin May Be More Effective Over Time

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Despite the controversy surrounding isotretinoin (the active ingredient in drugs like Accutane), there’s still lots of research going on regarding how to use it more effectively. Even the less troubling side effects of this type of acne medication can be pretty unpleasant. Some patients report hair loss, itching, nosebleeds, and mood changes as just a few of the problems they experience when taking isotretinoin. Unfortunately, one course of treatment doesn’t always clear up severe acne. Having to go through a second round of isotretinoin dosing is something most people would probably like to avoid.

Could New Information Influence Treatment Protocol?

Analysis of the data collected on 102 patients with severe acne has led to an interesting conclusion. It appears that patients who received a higher cumulative dose of isotretinoin over their initial course of treatment were less likely to need a second round to clear their acne. The researchers in this study suggest that treating patients with a higher dose (depending on tolerance) may be the best approach to effectively clearing severe acne over the long term.

The results of the analysis showed that the cumulative dose amount did not affect whether a patient required further acne treatment. In fact, about 45% of all patients in the study did have a relapse requiring prescription medication (other than isotretinoin) for their acne later. So, higher dosing doesn’t prevent acne recurrence altogether. It simply appears to limit the return of acne that is severe enough to require isotretinoin therapy.

Drawbacks of the Study

The sample size is small and the information was collected from existing patient charts rather than as part of a comparative trial. In addition, the patients who had 2 courses of isotretinoin were followed 2-3 times longer than those who did not. This makes it possible that the results are skewed. Data on the types and severity of side effects experienced by the patients was not assessed. Since some adverse reactions are dose dependent, this raises concerns about using the information in the study to determine appropriate treatment at this time.

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