The study looks at how often acne comes back after treatment with isotretinoin

Isotretinoin, commonly referred to as Accutane, is the only approved medical treatment that can provide long-term remission of severe acne. Although it is highly effective, some people experience a recurrence of acne after a course of treatment. A new study by researchers at Mass General Brigham looked at how often acne returns after isotretinoin and what factors may put patients at risk for acne recurrence. They found that acne recurrence requiring treatment with oral medication, such as oral antibiotics, spironolactone or another course of isotretinoin, occurred in about 1 in 5 patients, more often among women and those who had received lower cumulative doses. However, the daily dose was not predictive of acne recurrence, and the benefits of the higher cumulative dose were not seen beyond 220 mg/kg. The results are published in JAMA Dermatology.

These findings support that dosing regimens could be individualized according to patient goals and preferences. As long as an adequate cumulative dose is achieved, it appears that a lower and higher daily dose regimen may be effective. Since side effects are highly dose-dependent, these results can help clinicians work with patients to choose the best dose for them to balance risks and benefits.”

John Barbieri, MD, MBA, of the Department of Dermatology and Director of the Advanced Acne Therapeutics Clinic at Brigham and Women’s Hospital

Using data from MarketScan, this retrospective analysis looked at patients who had at least one prior diagnosis of acne and were treated with isotretinoin for at least four months and who had at least one year of follow-up data available. Of the 19,907 patients, 35% received a subsequent prescription acne treatment, with 22.5% taking oral medication. 8.2% were treated with a second course of isotretinoin. The researchers also found that female patients were at greater risk of experiencing a recurrence of acne, although they were less likely to be treated with a second course of isotretinoin. The researchers found that the highest cumulative dose of isotretinoin was associated with reduced acne recurrence, but not beyond 220 mg/kg.