Abstract

Background: Acne vulgaris is a chronic inflammatory disease of pilosebaceous units. Oral isotretinoin is recommended for patients with moderate-to-severe acne vulgaris who are not responding satisfactorily to conventional therapies. Recent reports indicate that acne patients have been benefiting from the low-dose treatment protocols. Aims and Objectives: The aim of this study was to assess and compare the efficacy of oral isotretinoin in low-dose continuous and intermittent treatment of moderate-to-severe acne vulgaris.
Materials and Methods: This was a prospective, randomized, open-labeled, comparative, efficacy study carried out at Outpatient Clinic in the Department of Dermatology in Mandya Institute of Medical Sciences, Mandya. Out of 120 patients screened, 100 patients were selected. Patients with moderate-to-severe acne were assigned equally (50 patients each) to one of the two treatment regimens using block randomization technique, Group A was given low- dose continuous regimen - 20 mg of oral isotretinoin once daily for 4 months and Group B was given low-dose intermittent th regimen - 20 mg of oral isotretinoin once daily for 1 week out of every 4 weeks. The patients were followed up every 4 week during the treatment period. A 6-month follow-up evaluation after the end of treatment was performed. The outcome of the therapy was based on the improvement in the global acne grading system (GAGS) score and patients’ satisfaction with the treatment in the 4-point scale.
Results: This study showed statistically significant clinical improvement and difference in GAGS score between Group A and Group B (P < 0.005). Conclusion: This study suggests that, considering clinical efficacy, low-dose continuous treatment is most suitable for patients with moderate-to-severe acne vulgaris.