What Happens After Isotretinoin? New Insights Into Post-Treatment Acne Care
Isotretinoin remains the gold standard for treating severe acne, but relapse after treatment is common, affecting 20 to 60% of patients. Despite this, consistent post-isotretinoin management guidelines are lacking.
To explore current practices, a pilot survey of dermatologists on the American Acne and Rosacea Society board revealed wide variation. Daily dosing strategies ranged from low (0.25 mg/kg) to high (1.0 mg/kg), and cumulative dosing goals were split between the standard 120-150 mg/kg and more aggressive targets above 200 mg/kg. Most dermatologists discontinued treatment after hitting both their dose goal and two months beyond clinical clearance.
Maintenance therapy showed inconsistency. While topical retinoids were the most commonly used, one-third of respondents didn’t initiate any post-treatment maintenance, despite high relapse rates. For those who did, most began maintenance immediately or within a month of stopping isotretinoin.
Relapse management differed by gender. Spironolactone was commonly used for females, while a second course of isotretinoin was more often prescribed for males. Most dermatologists modified dosing or duration for retreatment.
These findings highlight a lack of consensus in how to manage acne after isotretinoin. As relapse remains a key concern, there’s a clear need for standardized, evidence-based guidelines to help dermatologists maintain long-term treatment success.
J Drugs Dermatol. 2025;24(6):e38-e39.
