Safety and efficacy of fixed-dose 10mg daily isotretinoin treatment for acne vulgaris in Malaysia

IntroductionLow-dose isotretinoin is used to reduce side effects albeit higher relapse. This study aimed to determine the efficacy and safety of fixed-dose 10mg daily isotretinoin for the treatment of acne. MethodsThis prospective study was performed between 2011 and 2015. All 150 patients were given 10mg daily isotretinoin until a cumulative dose of 90-110mg/kg. ResultsThe mean age was 26.6years with 64.7% moderate acne, 29.3% severe, and 6% very severe. The mean cumulative dose was 98.86.05mg/kg. All 150 patients had total clearance with a mean time to clearance of 24.0weeks. Patients with severe/very severe acne had higher cumulative dosage (102.1 vs. 97.0, P<0.001) and longer duration to clearance (32.9weeks vs. 19.1weeks, P<0.001). Mild relapse was seen in 4%. The mean time to relapse was 32.3weeks. Lip dryness was the commonest side effects (100%). Mild transient elevation of liver enzymes was detected in 3.3% and a slight increase of serum lipid in 2.7% with no treatment discontinuation. ConclusionFixed-dose 10mg daily treatment with isotretinoin until a cumulative dose of 90-110mg/kg is safe with low relapse rate.