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In this retrospective study, 550 patients aged 10 to 24 years who completed at least 2 months of isotretinoin therapy for acne were identified. Most patients (67%) were normal weight or underweight, 18% were overweight, and 15% were obese. Overweight and obese patients had lower daily doses than others in the first 2 months of treatment, but all were in the 0.5 to 1.0 mg/kg/day range. Headaches were more common in overweight and obese patients. Acne clearance, recurrence, and time to recurrence after treatment discontinuation did not vary among the groups, with relapse rates ranging from 25% to 35%.
Current isotretinoin treatment strategies are appropriate and safe for overweight and obese young patients.
The response of obese and overweight young people to isotretinoin is understudied. This study compares isotretinoin treatment for acne in overweight and obese young people with their normal-weight peers to evaluate whether current dosing strategies (0.5-1 mg/kg/day for 120-150 mg/kg cumulative dose) are appropriate.1 We hypothesize that young people with a higher body mass index (BMI) may be effectively underdosed due to physicians' reluctance to prescribe higher daily doses of isotretinoin, potentially prolonging the treatment and impacting side effects. We hypothesize that there will be differences in daily dose (mg/kg), treatment length, and side effect incidence among the groups.