Efficacy, safety, and recurrence in seborrheic dermatitis: A dose-dependent analysis of oral isotretinoin (10 mg vs 20 mg).

BACKGROUND

This study aimed to compare the efficacy, recurrence rates, and patient-reported satisfaction of 10 mg versus 20 mg daily isotretinoin in individuals with moderate to severe seborrheic dermatitis.

METHODS

A retrospective cohort study was conducted on 234 patients treated with 10 mg (n = 126) and 20 mg (n = 108) isotretinoin. Disease severity was assessed using the Seborrheic Dermatitis Area Severity Index (SDASI), while quality of life and treatment satisfaction were evaluated using the Dermatology Life Quality Index (DLQI) and Treatment Satisfaction Questionnaire for Medication 9.

RESULTS

The 20 mg group demonstrated greater reductions in SDASI and DLQI scores at 12 months, suggesting improved disease control (P < .001). Recurrence-free probability was significantly greater in the 20 mg group at all time points (P < .001). Multivariate analysis identified the 20 mg dose as a protective factor against recurrence (odds ratio = 0.131, 95% confidence interval 0.037-0.459, P = .002), while baseline SDASI and DLQI scores did not independently predict recurrence. Receiver operating characteristic analysis indicated that baseline SDASI scores had limited predictive value for recurrence (area under the curve = 0.650, P = .027).

CONCLUSION

Both 10 mg and 20 mg isotretinoin effectively reduce disease severity in seborrheic dermatitis, but the 20 mg dose was associated with superior disease control, lower recurrence rates, and higher patient satisfaction.