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.
Cheers,
Dr David Deng
