Is high dose Accutane more effective in preventing acne relapse?
I'm a 20 years old male. I used to have very severe acne, but now I have mild acne. My dermatologist has started me on 10 mg isotretinoin on alternate days. She informed me that Isotretinoin cannot be given at a higher dose than 40 mg. I am interested to prevent an acne relapse, and was wondering if high dose Accutane is more effective in preventing acne relapse?
Oral isotretinoin is a very useful oral medication for treating severe acne, especially associated with scarring.
In your case, your doctor has started you on a relatively lower dose regimen of oral isotretinoin 10mg on alternate days. If this dosing regimen is working well for you in reducing acne relapses, then there is probably no need to use a higher dose regimen.
In fact, with a higher dose, there will be more expected side effects eg dryness on the skin, lips and eyes which can be quite uncomfortable for some patients.
Please also bear in mind that oral isotretinoin must never be taken by females who are pregnant or who are contemplating to get pregnant, as there is potential serious adverse side effects to the developing foetus.
So I would recommend you to speak to an experienced doctor in treating acne with oral isotretinoin to assess your condition and advise you further to optimise your dosing regimen.
Hope this helps!
Dr David Ng C H
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!
Dr Justin Boey
No, high dose accutane does not help prevent future acne. It's actually the total accumulated dose that you need to reach that will reduce the chance of relapse, and the dosage will depend on your body weight, the control of your acne and the serverity of your acne and the presence of side effects like dryness.
Your doctor should know so ask him/her to explain to you. Hope that helps!
The general consensus on the treatment of acne using oral isotretinoin has moved towards using low-dose. Not only is it safer (risks of complications and side effects- which my fellow colleagues have already covered), its efficacy has been proven to be equal to that of high dose oral isotretinoin and therefore also more economical. One example of many studies performed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4037971/
I would only recommend increasing the dose of oral isotretinoin in patients with severe acne refractory to lower doses, with proper follow up of blood tests and consultation.
Hope this helps.
Dr David Deng