Treatment of Mild to Moderate Acne with Conventional versus Two Different Intermittent Doses and Continuous Low-dose of Isotretinoin: A Randomized, Comparative Study

Background: Oral isotretinoin is a unique drug that affects all four basic pathogenic mechanisms and the most effective systemic drug currently available for treatment of acne vulgaris. In this study, we aimed to assess the efficacy and tolerability of two different intermittent doses and continuous low-dose and to compare them with the conventional dose of isotretinoin in the treatment of mild to moderate acne vulgaris.

Methods: Eighty patients with mild to moderate acne were enrolled and randomized to receive either isotretinoin at 0.5–0.7 mg/kg daily for six months (group A), isotretinoin at 0.5–0.7 mg/kg daily for 1 month, then daily for 1 week out of every 4 weeks for six months (group B), isotretinoin at 0.5–0.7 mg/kg daily for 1 week out of every 4 weeks for six months (group C) or isotretinoin at 0.25–0.4 mg/kg) daily for six months (group D).

Results: Patient satisfaction was highest among group D, followed by group C, then B, and then A with statistically significant differences between groups A and D (P = 0.003) and groups D and B compared to C (P = 0.019).Side effects were more frequent with conventional dose compared with two intermittent doses and continuous low-dose.

Conclusions: This study suggests that, when considering tolerability, efficacy and patient satisfaction, continuous low-dose treatment is most suitable for patients with mild to moderate acne.