If you’re experiencing recurring severe acne despite taking medication, this might be the reason
A new study from researchers at Mass General Brigham examined how often, acne recurs after isotretinoin, the only approved medical treatment capable of inducing long-term remission of severe acne.
The researchers also studied what factors might put patients at risk of acne coming back. Isotretinoin is commonly referred to as Accutane in US and other names in India. The study was published in JAMA Dermatology.
What the study found
The researchers found that approximately 1 in 5 patients experienced acne recurrence requiring treatment with oral medication such as antibiotics, spironolactone, or another course of isotretinoin. Moreover, this was more frequent among females and those who had taken lower cumulative dosages. However, the daily dose was not predictive of acne recurrence.
More about the study
This cohort study, which included 19 907 patients, found that 22.5 percent had acne relapse and 8.2 percent had isotretinoin retrial. Cumulative dosage was significantly associated with decreased rates of relapse and retrial (hazard ratio [HR], 0.99 for both); female patients were significantly associated with increased rate of relapse (HR, 1.43) and decreased rate of retrial (HR, 0.68); daily dose was not negatively associated with relapse or retrial among patients with cumulative dosages of 120 mg/kg or more.
This cohort study used data from the MarketScan commercial claims database from January 1, 2017, to December 31, 2020, to identify patients with acne who were 12 years or older and had received isotretinoin for four months or longer, with at least one year of continuous enrolment after completion of isotretinoin. Data analyses were performed from June 30, 2024, to August 1, 2024.
One of the researches, John Barbierim, said, “These findings support that dosing regimens could be individualised to patient goals and preferences. So long as a sufficient cumulative dose is reached, it appears that both lower and higher daily dose regimens can be effective. Since side effects are very dependent on dose, these results can help clinicians work with patients to pick the best dose for them to balance risks and benefits.”
Conclusions and relevance
The findings of this study suggest that higher cumulative dosage may potentially reduce the risk of acne relapse and isotretinoin retrial. Furthermore, daily dose was not associated with decreased risk of the outcomes for conventional and high cumulative dosage; therefore, daily dosing could be individualised to patient goals and preferences.
If you’re experiencing recurring severe acne despite taking medication, consult your dermatologist to rule out any underlying conditions and adjust your treatment plan accordingly.