Clinical trials and experimental
Treatment with low doses of isotretinoin in moderate acne
Background: 
Efficient classical administration of isotretinoin in the treatment of acne consisted in 0.5 to 1.0 mg/kg per day with a duration of treatment between 4 and 8 months reaching a cumulative dose of 120 mg/kg. This regimen causes many side effects that are usually dose dependent.

Objective: 
The purpose of this study was to determine the efficacy of low-dose isotretinoin in the treatment of moderate acne.

Methods:
In this prospective, noncomparative study, 102 patients, both male and female, between 15 and 30 years old, with moderate acne were enrolled and treated with isotretinoin at 20-30 mg/day (approximately 0.3 mg/kg per day) for 8 months, the mean total dosage being 72 mg/kg. The clinical and laboratory evaluations were done at the end of the first, 4-th, 6-th and 8-th months of treatment. The follow-up period was one year after the treatment was finished.

Results: 
At the end of the treatment very good and good results were observed in 97.9% of the patients. Seven patients dropped out of the study because of lack of compliance, one patient stopped the treatment because of worsening depression and another patient discontinued participation because of a severe hyperlipidemia. The most common cutaneo-mucous side effect was cheilitis in 97.9% followed by mild xerosis in 62.1%, reduced night vision in 3.15%, headache in 2.1% and epistaxis in 5.26%. Elevated serum lipid levels (up to 10% higher than the upper limit of normal value) were found in 9.47% of the patients and mild and transient abnormal liver tests were observed in 3.15%. In the 1-year follow-up relapse appeared in one patient.

Conclusion: 
Treatment with low-dose isotretinoin of 0,3 mg/kg/day was found to be effective in the treatment of moderate acne,  ith a low incidence of severe side effects and at a lower cost than higher doses.