Oral Isotretinoin for acne treatment; adolescents versus adults
Research type
Research Study
Full title
Oral Isotretinoin: dose, side effects and relapse. Retrospective cohort study comparing treatment in adolescents and adult.
IRAS ID
300242
Contact name
Claire Martyn-Simmons
Contact email
Sponsor organisation
University College London Hospital Trust
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Oral isotretinoin has been used for moderate to severe acne for the last four decades and it has proven to be a major pharmacological breakthrough since it can induce acne clearance with prolonged duration of remission.
The daily dosage of Isotretinoin ranges from 0.1 mg/kg/day to 1 mg/kg/day. Initial studies supported high daily dosage to achieve acne clearance and reduce the risk of recurrence. However, higher dosage is associated with greater adverse effects. There are now an increasing number of reports supporting low daily dosage, which achieves acne clearance with reduced adverse events.
Most studies support attainment of a cumulative dose of 120-150 mg/kg to reduce risk of relapse. It has been now suggested that the duration of sebaceous gland suppression is better indicator of risk of relapse. In particular, high-dosage of Isotretinoin achieves sebaceous gland suppression for prolonged period of time compared to low-dosage Isotretinoin. Therefore, low-dosage regime needs to be continued for longer than high-dosage regime to achieve the same length of sebaceous gland suppression.
Acne is no longer a condition limited to adolescents and young adults (< 25 years old). Adult acne (> 25 years old) is defined either as continuation or recurrence of adolescent acne or late onset acne. A recent study reported that treatment of adolescent acne with isotretinoin reduces the risk of acne occurrence in adults.
We aim to identify adolescents and adults that received Isotretinoin treatment via our electronic records. Eligible participants will be invited to participate in telephone consultation or online questionnaire. We aim to evaluate acne clearance rate and symptomatic side effects in the two groups (adolescents and adults), the incidence of acne recurrence and whether low daily dosage had an effect on risk of recurrence, side effects and initial acne flare.
REC name
South West - Central Bristol Research Ethics Committee
REC reference
22/SW/0135
Date of REC Opinion
4 Oct 2022
REC opinion
Further Information Favourable Opinion