Lai J, Barbieri JS . JAMA Dermatol. 2025;161(4):367.
Studies assessing rates and risk factors for acne relapse after isotretinoin therapy have yielded varied results. In a retrospective study of data from over 19,000 patients treated with isotretinoin in the United States, 23 percent of patients relapsed after treatment; higher cumulative dose was associated with a reduced risk for relapse, while female sex was associated with an increased risk for relapse The daily dose did not influence the risk for relapse among patients treated with at least a conventional cumulative dose (120 mg/kg). The findings support cumulative dose as a risk factor for relapse and suggest that individualizing the daily dose to support drug tolerability may be reasonable in patients who will receive at least a conventional cumulative dose of isotretinoin.