What can cause a post-Accutane (isotretinoin) relapse?

Doctor's Answers 1

Isotretinoin is a very effective oral medication for acne vulgaris and most patients on oral isotretinoin are able to achieve excellent control of their acne.

Patients are often on the oral isotretinoin for several months and on discontinuation of treatment, many patients are able to remain clear of their acne. However, some patients do experience a relapse of their acne on discontinuation of the isotretinoin.

There are a few possible reasons for this.

  • The patient may have been on too short a course of isotretinoin. Generally, the risk of relapse is less if the patient is continued on the isotretinoin for a longer period of time.
  • Some patients may have a persistence of the factors that predispose to acne e.g. hormonal triggers, diets, stress etc.

While many people outgrow their acne, about 30% of individuals can have persistent adult acne.

If the acne has a tendency to relapse on discontinuation of the isotretinoin, a low dose of isotretinoin for a longer duration may help to keep the acne under control with fewer side effects from the isotretinoin.

Similar Questions

Can I undergo fractional C02 or Infini treatment while on low dose Isotretinoin?

Sorry to hear that you are suffering from acne scars. Low dose isotretinoin (Accutane) is increasingly being used for acne. Many patients on isotretinoin also have scarring from previous acne. It is best to start scarring treatment early, but there remains some concern with abnormal scarring while on isotretinoin. Can you undergo fractional CO2 or Infini treatment while on low dose Isotretinoin? It is safe to proceed with fractional CO2 laser or radiofrequency microneedling while on low dose Isotretinoin.

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Answered By

Dr Wan Chee Kwang

Aesthetic

Is high dose Accutane more effective in preventing acne relapse?

If your current dosing regime of 10 mg of isotretinoin on alternate days is working well, there is no need for a higher dose of Accutane. Higher doses of Accutane are associated with more side-effects such as dryness of mucous membranes (eg lips and eyes). There is also a possibility of your liver function and cholesterol levels being affected. I understand that you are interested to prevent an acne relapse. I recommend that you continue at your current dosage of isotretinoin especially if it gives you results without major complications. Hope that this helps!

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