Relapse

Relapse can occur post-isotretinoin therapy. A large study (17,351 first time isotretinoin users over a 20-year period) looked at the prescriptions given to this cohort. It identified that 41% of the patients required further acne treatments (isotretinoin or other systemic or topical therapy). Twenty six percent required a second dose of isotretinoin (Azoulay et al., 2007). The authors looked for predictive factors for relapsing and noted that male subjects and those under the age of 16 were more likely to require further treatment with anti-acne medications. Those who had lower doses and shorter courses also seemed more at risk of needing subsequent anti-acne treatments. Generally, it seems to be the case that if relapse is going to occur it occurs most frequently in the first year post-treatment (Gollnick et al., 2003).