Board Certified in Dermatology
Recommended for: Board Certified in Dermatology +-1
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In my opinion, you are 25 mg / kg short of your ideal cumulative dose of isotretinoin. Around 80% of patients who receive a total dose of 120 mg / kg relapse, while only 30% of patients with a total dose of 150 mg / kg relapse. Thus, the dose over one course of treatment should be at least 120 mg / kg body weight and ideally 150 mg/kg body weight. 20 mg daily x 30 days (1 month) x 11 months = 6,600 mg cumulative dose divided by 53 kg = 125 mg total dose.
It generally takes 8-12 weeks for isotretinoin to improve acne. Its effect depends on the dose, which your dermatologist will determine together with you based on body weight and response. Maximum improvement can be expected after 16 weeks. I typically start patients on 20 mg / day. This allows for monitoring of any adverse effects and allows the patient to become accustomed to isotretinoin. The daily dose can be gradually increased each month by an additional 20 mg to a dose of approximately 1 mg/kg body weight. Although lower doses may achieve the same initial response rates, they are associated with a much higher recurrence rate on discontinuation of isotretinoin. For severe acne, the total dose over a course of treatment is ideally between 120 and 150 mg/kg body weight.
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