Variability and Predictors of Isotretinoin Dosing in Acne Patients: A Retrospective Cohort Study

Clicks: 3
ID: 316026
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Popular

Ranked #101 of 176 articles by views in clinical and experimental dermatology

Most read Least read

Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 176 in total.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
BACKGROUND: Isotretinoin prescription for acne varies widely, partially due to inconsistent guidelines. This leaves physicians to rely on clinical judgment, experience, and institutional practices. OBJECTIVES: We examined real-world isotretinoin prescribing patterns among dermatologists in a large healthcare system, focusing on dosing variability and predictors of total cumulative dosage. METHODS: This retrospective cohort study at Kaiser Permanente Northern California (KPNC) included 9,551 KPNC members aged 13-40 years who received ≥1 isotretinoin prescription for acne from January 1, 2016, through December 31, 2022. The primary outcome was cumulative isotretinoin dose (mg/kg). Secondary outcomes included starting and maximum daily doses, time-to-maximum dose, and total treatment duration. RESULTS: Among 9,551 participants, most were <18 years old (N=5,609 (59%)), with an equal gender split (female: N=4,911 (51%)). Common starting doses were 0.5-0.75mg/kg/day (N=4,809 (52%)), with 35% reaching a maximum of 1-1.25mg/kg/day. Mean cumulative dose was 136.6 mg/kg (SD=62.5), with 25% of patients receiving 120-150 mg/kg, consistent with the 2016 American Academy of Dermatology guidelines. Doses >175mg/kg were used in 24.8%. Significant predictors of higher cumulative dosing included female sex, younger age, prior antibiotic use, and more acne-related visits. Additionally, Asian and White patients received significantly higher cumulative doses compared to Black patients. CONCLUSIONS: This study highlights substantial variability in isotretinoin prescribing practices. Although medium-range cumulative doses aligned with previous guidelines, there was substantial variability in cumulative dosing. These findings highlight the need for comparative studies of alternate dosing strategies. More comprehensive guidelines incorporating alternative dosing models could optimize acne treatment and ensure equitable care.
Reference Key
openalex_W7163657590 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Noah Contreras, Michael Hartmann, A. S. Lieberman, Andrew L. Avins, Veena Vanchinathan
Journal clinical and experimental dermatology
Year 2026
DOI
10.1093/ced/llag225
URL
https://doi.org/10.1093/ced/llag225
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.