Low-cumulative dose isotretinoin treatment in mild-to-moderate acne: efficacy in achieving stable remission

J Eur Acad Dermatol Venereol. 2011 Sep;25(9):1094-8. doi: 10.1111/j.1468-3083.2010.03933.x. Epub 2010 Dec 29.


Background: Aimed at the reduction of post-treatment relapse of severe acne, the cumulative dose of oral isotretinoin should be ≥120 mg/kg. However, data on the appropriate oral isotretinoin treatment regimen in mild and moderate acne are lacking.

Objective: The purpose of this study was to determine the efficacy of an isotretinoin-sparing protocol in inducing permanent remission of mild and moderate acne.

Methods: In this open, prospective, non-comparative study, 150 patients affected with mild-to-moderate acne were treated with isotretinoin until complete recovery and for a further month of treatment, independent of the total cumulative dose reached. Patients then underwent a 1-year maintenance therapy with adapalene 0.1% cream. Patients were followed up for a further year, without any treatment.

Results: A total of 139 patients completed the study. Overall, patients received a mean of 80.92 mg/kg cumulative dose of isotretinoin. In the 2-year follow-up, relapse only appeared in 13 patients (9.35%).

Conclusion: Comparing our findings with published data, this isotretinoin-sparing regimen was shown to be effective in inducing stable remission and preventing acne relapses in patients with mild-to-moderate acne. Low-cumulative dose regimens may potentially lead to a lower incidence of side-effects and to lower costs than higher doses.

Publication types

  • Clinical Trial

MeSH terms

  • Acne Vulgaris / drug therapy*
  • Adapalene
  • Dermatologic Agents / therapeutic use*
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Isotretinoin / therapeutic use*
  • Male
  • Naphthalenes / administration & dosage
  • Prospective Studies
  • Remission Induction


  • Dermatologic Agents
  • Naphthalenes
  • Adapalene
  • Isotretinoin