For long standing cystic acne, what are my treatment options if even Accutane (Isotretinoin) fails to result in any improvement?

Doctor's Answers (1)

Dr Chin Yee Choong

"Dedicated to the ethical practice of Aesthetic Medicine"


It is highly unlikely that isotretinoin will fail to result in any improvement in cystic acne if adequate dosing is used.

A higher dose of 0.5-1mg/kg/day may be needed to suppress more recalcitrant cystic acne. Sometimes it may take up to 6 months before the inflammatory acne can be fully controlled.

At the same time, complications of gram-negative folliculitis requiring the use of appropriate oral antibiotics need to considered.

Adjuvant treatment such as intralesional steroids and hormonal therapy (in females) may give additional benefits. A healthy lifestyle reducing stress and avoiding high glycaemic index foods and excessive dairy products will also help control acne better.

A regular review by your attending doctor will definitely help sort out the various issues highlighted above.

Hope this helps!

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