How is management of severe acne?

• In addiWon to topical treatment, systemic treatment with isotretinoin is indicated for cystic or conglobate acne, or any other acne refractory to treatment • This retinoid inhibits sebaceous gland function and keratinization, which is very effective. Oral isotreWnoin leads to complete remission in almost all cases, lasting for months to years in the majority of patents • Indications for Oral Isotretinoin: Moderate, recalcitrant, and nodular acne • Contraindications: Isotretinoin is teratogenic and effective contraception is imperative. Concurrent tetracycline and isotretinoin may cause pseudotumor cerebri (benign intracranial swelling). Therefore, the two medicaWons should never be used together Isotretinoin, 0.5 to 1 mg/kg daily given in divided doses with food to a total goal dose of 120 to 150 m