Italian journal of dermatology and venereology · 2026
Oral isotretinoin and acne clearance: the role of daily dosage in a real-world clinical setting.
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Marzola Elisa, Pedarzani Emma, Valpiani Giorgia, Fraternale Sofia, Toni Giulia, Bettoli Vincenzo, Corazza Monica, Borghi Alessandro
Аннотация
BACKGROUND: Complete acne resolution with oral isotretinoin has not been specifically addressed. We aimed to assess the achievement of acne clearance with particular focus on oral isotretinoin daily dosage.
METHODS: This single-center, retrospective study included a cohort of acne patients treated with oral isotretinoin at our Acne Clinic between January 2014 and December 2023. The key aspects investigated were the rate of patients who achieved acne clearance at face, chest and back, the incidence of adverse effects and the relevance of the daily oral isotretinoin dosage in relation to these two outcomes.
RESULTS: Of the 359 patients included (61.3% males, 38.7% females), 217, 61.6% of those with facial involvement, achieved complete clearance of face acne, 101 (46.1%) achieved clearance of back acne and 89 (75.4%) a complete recovery of chest acne. A mean daily dosage between >10 and 20 mg was associated with a higher probability of complete resolution of acne, especially at chest, compared to lower dosages. Mean daily doses higher than 20 mg were not associated with a greater probability of clearance compared to lower dosages, while they were associated with an increased side effects' occurrence.
CONCLUSIONS: The daily dosage of oral isotretinoin does not appear to be a determining factor in achieving acne clearance, while it may influence the incidence of side effects. A mean daily dosage ranging from >10 to 20 mg may represent an optimal balance, ensuring therapeutic efficacy while limiting the risk of adverse events.
METHODS: This single-center, retrospective study included a cohort of acne patients treated with oral isotretinoin at our Acne Clinic between January 2014 and December 2023. The key aspects investigated were the rate of patients who achieved acne clearance at face, chest and back, the incidence of adverse effects and the relevance of the daily oral isotretinoin dosage in relation to these two outcomes.
RESULTS: Of the 359 patients included (61.3% males, 38.7% females), 217, 61.6% of those with facial involvement, achieved complete clearance of face acne, 101 (46.1%) achieved clearance of back acne and 89 (75.4%) a complete recovery of chest acne. A mean daily dosage between >10 and 20 mg was associated with a higher probability of complete resolution of acne, especially at chest, compared to lower dosages. Mean daily doses higher than 20 mg were not associated with a greater probability of clearance compared to lower dosages, while they were associated with an increased side effects' occurrence.
CONCLUSIONS: The daily dosage of oral isotretinoin does not appear to be a determining factor in achieving acne clearance, while it may influence the incidence of side effects. A mean daily dosage ranging from >10 to 20 mg may represent an optimal balance, ensuring therapeutic efficacy while limiting the risk of adverse events.