Safety and efficacy of fixed‐dose 10 mg daily isotretinoin treatment for acne vulgaris in Malaysia

Introduction
Low‐dose isotretinoin is used to reduce side effects albeit higher relapse. This study aimed to determine the efficacy and safety of fixed‐dose 10 mg daily isotretinoin for the treatment of acne.

Methods
This prospective study was performed between 2011 and 2015. All 150 patients were given 10 mg daily isotretinoin until a cumulative dose of 90–110 mg/kg.

Results</jats:title><jats:p>
The mean age was 26.6 years with 64.7% moderate acne, 29.3% severe, and 6% very severe. The mean cumulative dose was 98.8 ± 6.05 mg/kg. All 150 patients had total clearance with a mean time to clearance of 24.0 weeks. Patients with severe/very severe acne had higher cumulative dosage (102.1 <i>vs</i>. 97.0, <i>P</i> < 0.001) and longer duration to clearance (32.9 weeks <i>vs</i>. 19.1 weeks, <i>P</i> < 0.001). Mild relapse was seen in 4%. The mean time to relapse was 32.3 weeks. Lip dryness was the commonest side effects (100%). Mild transient elevation of liver enzymes was detected in 3.3% and a slight increase of serum lipid in 2.7% with no treatment discontinuation.

Conclusion
Fixed‐dose 10 mg daily treatment with isotretinoin until a cumulative dose of 90–110 mg/kg is safe with low relapse rate.