Isotretinoin in treatment of acne: its efficacy, side effects, and recurrence rate of disease.

BACKGROUND: Acne is a chronic inflammatory disease of pilosebaceous units. In addition to an unpleasant appearance, it may result in scarring in some cases. Despite the introduction of different treatments, oral isotretinoin is the most effective treatment and affects all the factors involved in the pathogenesis of this disease. This study was performed on patients with acne to examine the therapeutic effects, recurrence rate, and adverse effects of this drug. METHODS: One hundred patients with acne, who were visited at the Bou-Ali Hospital during 2000 - 2001, and found eligible to take part in this study were selected. The severity of acne was graded at the beginning, during, and after a 6-month treatment course with oral isotretinoin. Necessary laboratory tests were done. RESULTS: The data of 83 of 100 patients who continued the treatment for 6 months were analyzed. The mean +/- SEM severity score of acne improved from 3.15 +/- 0.10 to 0.58 +/- 0.09 (P < 0.0001). Complete cure was achieved in 65% of patients. The mean +/- SEM follow-up was 8.7 +/- 2.3 months and the acne severity score was 1.04 +/- 0.13 during the follow-up period. Overall, the recurrence rate was 19%; 4% of patients had to undergo retreatment. A rise in triglyceride level was the only significant laboratory alteration observed. CONCLUSION: Oral isotretinoin appears to have favorable results and the least adverse effects in treatment of carefully-selected patients with acne.