Isotretinoin 5mg capsules (once daily) in the treatment of persistent low grade adult acne.

Isotretinoin is a retinoid, structurally related to vitamin A, which has been used orally in human medicine for more than 20 years in the treatment of severe acne resistant to other treatments. A large body of published data, from both human and animal studies, suggests that the clinically useful action of isotretinoin is to reduce both the size and secretory capacity of sebaceous glands. Although isotretinoin has no significant in vitro antibacterial activity, when used orally to treat acne it causes a significant reduction in the numbers of skin bacteria. This effect is generally believed to be secondary to its action in reducing sebum production and may contribute to its useful action in treating acne. Some recent publications suggest lower doses of isotretinoin may be a useful alternative for patients who present with less severe acne. The clinical efficacy of treating specific patient groups with a daily low dose alternative to complicated periodic or interrupted dose schedules with higher strength capsules needs further investigation.