Isotretinoin therapy in acne and modern practice

Since its introduction into widespread use in the early 1980s, isotretinoin has been a dramatically successful therapy for severe and persistent acne. Initially used only for severe cystic acne, its use has been gradually extended for those with significant but milder disease that has been persistent despite the use of conventional topical and oral therapies. It has an important role in those with scarring because of their acne, and also in those with dysmorphophobia. Most studies indicate a success rate of almost 100%, and confirm that approximately two-thirds of patients have no relapse when treatment is discontinued. However, it is not clear whether these figures are correct for the patient profile now being treated. The existing licence does not cover current accepted usage.