Cystic Acne
Hi Doc, i am having problem of cystic acne on my face.Now doc is about to start treatment for permanent removal of all these.he has prescribed my tablet-Isotorin -20mg for two months,right now.I have read about this online.Now i am getting furious about this,should i go for this medicine or not. I have done some test-SGOT,SGPT,ALP,SERUM,CALCIUM.all test are positive.So please suggest,doc told me there is chance of some side effects,but those ll be temporary also acne may flare up in the starting of treatment.So i have some queries: 1.Is there any other medicine with less side effect however having same functionality of this medicine? 2.If acne flare up,then up to which extent it ll? i ll be having same situation i had before starting treatment,or it ll be worse or it ll be less? 3.Instead of Isotorin 20mg can i start with 5mg? 4.whats the possibility of having side effects? 5.Are these effects temporary or permanent? Should i go with this or not??please HELP
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Dr. Manoj Agarwala
Dermatologist 11 yrs exp Delhi

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Thanks for the query. I will answer your queries pointwise 1) There is no better drug than isotretinoin for acne , it works on the all the 4 main causes of acne 2) There is a possibility of acne flare up on starting isotretinoin however small it may be, The flare is more if initial doses are high and for male patients. In India, traditionally we never start with high doses, so that chance is relatively less. However if it flares, it can be well controlled and there is no reason to panic. 3) 5 mg will be a baby dose for your age and it will take very long for the treatment process to be completed. Ideally one needs 125mg multiplied by owns body weight for one course of isotretinoin treatment i.e. if you are 60kg, then isotretinoin needed will be 125 x 60 = 7500mg. So if you take 40mg daily for 7 months, the target will be achieved. Beyong the dosage calculation, several other factors interplay and it imay be complicated for you to understand. Have faith on your treating Dermatologist though you can express your concerns. 4) Side effects can happen and that is the reason you need periodical blood tests and follow-ups to foresee them and prevent them. 5) Effects are both temporary and permanent, Discuss with the Dermatologist * Another important point to be remembered at your age is, If you are planning for conception, isotretinoin cannot be prescribed. Going ahead with the treatment is your decision based on facts listed above,
Next Steps
Meet a Dermatologist. There may be other ways of treatment without isotretinoin.
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