How long do I need to take isotretinoin (roaccutane) for?
Isotretinoin is taken as a course of treatment. An average course of treatment lasts 6-12 months.
Different dermatologists have differing approaches to the prescription of isotretinoin. The principles are that you complete a course of treatment that leads to a long lasting improvement in your skin even when the course is completed. My approach is to prescribe a course of treatment according to your body weight - for each kilogram that you weight you need to complete a total of around 120mg of isotretinoin. For example, if you weight 60kg, you need to take 60x120 i.e. 7200mg for the entire course. If you are taking one 20mg tablet of isotretinoin per day this would take a total of 360 days - almost a year.
You will start with a relatively low dose since there can be a temporary flare in your acne at the beginning of treatment and to allow you to get used to any side effects. After the first month or so the dose can be increased since this will shorten the duration of treatment - for example if you take two 20mg tablets daily then the length of the course is halved, although this must be balanced against the increased potential for side effects.
How can I help
I see patients in person in central London. An in person consultation allows me to examine the skin directly including features that are difficult to capture in a photograph such as 3-dimensional changes and textural change. This is the better option where the diagnosis is uncertain, where previous treatment has not been effective, or where a procedure is being considered. For more straightforward conditions such as acne and rosacea a remote consultation with clear photographs can be a good option.
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