Low-Dose Accutane Good for Mild Acne
HEALTH NEWS BITE
Monday, May 15, 2006
People suffering from mild cases of acne can benefit significantly from small doses of Accutane and other tretinoin-based acne treatments, a new study finds. Conducted by researchers at Israel's Soroka University, the study found that low-dose Accutane was also an effective means of reducing the side effects of inflammation and dryness that have been associated with Accutane in past research. For the purposes of the study, "low-dose" was defined as 20 milligrams of Accutane daily over the course of six months. At that dosage, researchers found that a remarkable 95% of patients experienced either complete remission of their acne or significant improvement at minimum.
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Oral isotretinoin as part of the treatment of cutaneous aging.
Hernandez-Perez E, Khawaja HA, Alvarez TY.
Center for Dermatology and Cosmetic Surgery, San Salvador, El Salvador.
[email protected]
BACKGROUND: A number of drugs have been used to prevent aging changes. However, studies of oral isotretinoin, the commonly used acne drug, as an antiaging drug are lacking. OBJECTIVE: To determine improvement in cutaneous aging utilizing oral isotretinoin combined with different procedures of facial rejuvenation. METHODS: Sixty patients ranging in age from 35 to 65 years, in whom additional modalities of rejuvenation were also used, were randomly assigned to receive treatment with oral isotretinoin (10-20 mg three times a week for 2 months, group A). Their results were compared with 60 patients who had undergone the same surgical procedures but with no oral isotretinoin (group . RESULTS: All patients treated with oral isotretinoin noted improvement in wrinkles, thickness and color of the skin, size of pores, skin elasticity, tone, and reduction in pigmented lesions and mottled hyperpigmentation. A statistically significant difference was found in the improvement of group A (Wilcoxon test <0.01). Using minimal amounts of this drug, the side effects were practically negligible. CONCLUSION: Utilizing various procedures with oral isotretinoin allowed us to improve the effects of cutaneous aging. Our results using isotretinoin in these cases have been satisfactory. We believe that this is one of the first reports of the use of oral isotretinoin in intrinsic and photoaged skin.
Publication Types:
Low-dose isotretinoin in the treatment of acne vulgaris.
Amichai B, Shemer A, Grunwald MH.
Huzot Clinic of Clalit Health Services, Ashkelon, Israel.
BACKGROUND: The efficacy of isotretinoin at 0.5 to 1.0 mg/kg per day in the treatment of acne is well established and considered safe, although it is sometimes not easily tolerated because of its cutaneous side effects. OBJECTIVE: The purpose of this study was to determine the efficacy of low-dose isotretinoin in the treatment of acne. METHODS: In this prospective, noncomparative, open-label study, 638 patients, both male and female, with moderate acne were enrolled and treated with isotretinoin at 20 mg/d (approximately 0.3-0.4 mg/kg per day) for 6 months. The patients were divided into two age groups: 12 to 20 and 21 to 35 years old. Patients were evaluated at 2-month intervals by means of clinical and laboratory examinations. A 4-year follow-up was also carried out. RESULTS: At the end of the treatment phase, good results were observed in 94.8% of the patients aged 12 to 20 years, and in 92.6% of the patients aged 21 to 35 years. Failure of the treatment occurred in 5.2% and 7.4% of the two groups, respectively. Twenty-one patients dropped out of the study because of lack of compliance, and another patient discontinued participation because of a laboratory side effect. During the 4-year follow-up period, relapses of the acne occurred in 3.9% of the patients aged 12 to 20 years and in 5.9% of the patients aged 21 to 35 years. Elevated serum lipid levels (up to 20% higher than the upper limit of normal value) were found in 4.2% of the patients and abnormal (<twice the upper limit of normal values) liver tests were observed in 4.8%. LIMITATIONS: This was a noncomparative, open-label study. CONCLUSION: Six months of treatment with low-dose isotretinoin (20 mg/d) was found to be effective in the treatment of moderate acne, with a low incidence of severe side effects and at a lower cost than higher doses.
PMID: 16546586 [PubMed - in process]
Very low dose isotretinoin is effective in controlling seborrhea.
Geissler SE, Michelsen S, Plewig G.
Department of Dermatology and Allergology, Ludwig-Maximilian-University, Munich.
BACKGROUND: Excessive seborrhea, coarse-pored skin, minimal acne and oily scalp hair comprise a well-known clinical entity. It causes considerable concern, has social impact, and affects the quality of life in some individuals. Some patients seek treatment for seborrhea. No effective topical sebosuppressive medication is available. Oral isotretinoin is the only remedy for men. In women, oral isotretinoin is the most effective remedy, followed by antiandrogens. PATIENTS AND METHODS: Eleven patients in three groups were treated for 6 months with very low dose isotretinoin. The influence on seborrhea was measured during oral treatment with 5 mg/d, 2.5 mg/d, or 2.5 mg 3x weekly. RESULTS: Sebum production, measured with Sebutape, was reduced by up to 64%. Acne lesions regressed by as much as 84%. Follicular filaments were reduced by 66%. Microcomedones were reduced on average up to 86%. Quantitative bacteriology showed a reduction of Propionibacterium acnes but no increase of Staphylococcus epidermidis. Biopsies revealed a 51% reduction in sebaceous gland size. With Bentonite, a reduction of lipids was demonstrated with 2.5 and 5 mg isotretinoin/d but not with 2.5 mg 3x weekly. There was a shift within the lipid fractions: triglycerides dominated, followed by squalenes and free fatty acids. CONCLUSIONS: Good results were achieved in all patients. The small number of patients did not permit a statistical analysis of the three isotretinoin doses studied, but there was a tendency toward better results with the two higher doses.
PMID: 16285647 [PubMed - indexed for MEDLINE]
Low dose isotretinoin combined with tretinoin is effective to correct abnormalities of acne.
Plewig G, Dressel H, Pfleger M, Michelsen S, Kligman AM.
Department of Dermatology and Allergology, Ludwig-Maximilian-University Munich, Germany.
[email protected]
BACKGROUND: Isotretinoin is well known in the therapy of acne papulopustulosa and acne conglobata. No study has investigated the pathophysiological changes of the skin of acne patients, especially when low dose oral isotretinoin is given in combination with topical tretinoin. PATIENTS AND METHODS: 28 patients were treated for 6 months with oral isotretinoin. In the acne conglobata group (A-C) patients were treated with 10 mg (Group A) or 20 mg isotretinoin (Groups B, C) in combination with topical 0.05% tretinoin cream. Group C was treated the first 2 weeks with 0.05% betamethasone valerate cream instead of tretinoin cream. In the acne papulopustulosa group, the patients received 0.5 mg isotretinoin/kg bodyweight and 0.05% tretinoin cream, either alone (Group E), or with oral methylprednisolone during induction (Group D). RESULTS: Acne conglobata--A reduction of inflammatory lesion by 87-94% and of non-inflammatory lesions by 81-88% was achieved (Groups A-C). A reduction of sebaceous gland size by 35-58%, sebum production by 90-95%, follicular keratinization by 55-70% and Propionibacteria by 33-73% was seen (Groups B and C better than Group A). In Group A the amount of lipids was only reduced by 6%, in Group B by 35% and in Group C by 40%. Acne papulopustulosa--Sebum excretion rate and follicular keratinization were reduced in Group D by 89% and 50% respectively, with isotretinoin alone by 94% and 53%. The amount of lipids was reduced in Group D by 40% and in Group E by 21%. CONCLUSIONS: Because of the efficacy and cost-benefit relationship of isotretinoin in the treatment of acne compared to other therapeutic approaches, further use low dose isotretinoin in the described settings seems to justified.
