Acne recurrence risk factors

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• In this case–control study, patients with nodulocystic acne being treated with a second course of isotretinoin due to relapse were compared with controls who successfully cleared after a single course of isotretinoin. Patients who had relapsed and required a second course were more likely to have received a lower cumulative dose (128.1 vs 159 mg/kg; P < .005) and have had a shorter duration of therapy after acne clearance was achieved (32 vs 65.4 days; P < .005).

• This study suggests that not only are cumulative dose and treatment duration predictors of acne relapse, but so is the duration of treatment after acne clearance is achieved. Treating patients for an additional 2 months after clearance may decrease rates of acne relapse and the need for a second course of isotretinoin.

– Margaret Hammond, MD

Abstract 

Oral isotretinoin has been used for decades to treat moderate to severe recalcitrant nodulocystic acne.1 One way to evaluate the effectiveness of treatments is to measure relapse rates after treatment completion. Prior studies have found factors such as cumulative dose, male gender, young age, severity, and treatment duration to be associated with acne recurrence after isotretinoin.2-5 We sought to further investigate factors associated with relapse after isotretinoin.

Journal of the American Academy of Dermatology

Analysis of Factors Associated With Relapse in Patients on Their Second Course of Isotretinoin for Acne Vulgaris

J Am Acad Dermatol 2020 Oct 20;[EPub Ahead of Print], PT Tran, HS Berman, E Leavitt, M Hogeling, CE Cheng

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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