Updates in Isotretinoin

Isotretinoin therapy has been studied a great deal over the past decade, with new understanding about its use in the treatment of acne vulgaris. Optimal dosing for isotretinoin therapy has yet to be elucidated, although data supports that lower relapse rates are seen with higher cumulative doses of medication. New evidence suggests that monthly laboratory monitoring may not be needed for healthy patients on isotretinoin therapy and instead a lipid profile and liver function tests may be completed at baseline and after 2 months of therapy or when the maximum dose has been achieved. Additional testing may be warranted for severe abnormalities and comorbid medical conditions. A causative link between isotretinoin and depression has not been found, but given the high prevalence of depression in patients with acne, screening is still warranted. Current evidence suggests that it is not necessary to wait 6 months post isotretinoin to undergo scar revision and resurfacing procedures.