Getting to the Root of Acne
September 2002
Déjà vu
An update from the summer AAD meeting.
We’ve been here before; it’s déjà vu all over again. That’s how well-known acne treatment expert Alan Shalita, M.D., summed up the latest in acne therapies when he spoke at this summer’s American Academy of Dermatology meeting in New York City.
Dr. Shalita, who is professor and chair of dermatology at SUNY-Downstate in Brooklyn, NY, made reference to the recent use of phototherapy to treat acne and likened this approach to one he remembers from his early days of practice.
“When I started my residency, it was very common to use hot quartz for treating acne,” said Dr. Shalita during his AAD plenary session presentation. “Many of us thought that was a lot of voodoo, but it’s a fact that about 70% of acne patients are better in the summer. There’s also a camouflage effect from tanning, and you do dry up inflammatory lesions — however UV light is comedogenic and carcinogenic.”
Porphyrins and P. Acnes
About 28 years ago, Dr. Shalita and a colleague described the porphyrins in Propionibacterium acnes while working at Columbia University.
“We easily detected these using a Wood’s light and fluorescence,” explained Dr. Shalita. “But for some reason, we never thought of shining a light on these porphyrins to aggravate them.”
According to Dr. Shalita, research has shown that the porphyrins in P. acnes are much more sensitive to 410-nm or 420-nm light than any other wavelength. This therapeutic approach eradicates
P. acnes, assuming you have a critical mass of P. acnes to start with, said Dr. Shalita. “You can see that in most patients the density of the acne decreased very dramatically,” he added.
In addition, this wavelength has a significant effect on intracellular lesion models and interleukin — all of which are involved in the pathogenesis of acne.
Topical Retinoids for Inflammatory Acne
Using topical retinoids to treat inflammatory acne isn’t a new concept, said Dr. Shalita. It’s actually an old concept that’s now receiving increasing attention. As you know, the microcomedo is the precursor of all other acne lesions, and it’s best treated with retinoids.
When Dr. Shalita was a resident at the Skin and Cancer Unit at New York University, he and colleagues demonstrated that most comedones and inflammatory lesions dramatically improved when topical retinoids were applied.
“At this time, we used tretinoin swabs, which were way too irritating for the average practitioner to use,” explained Dr. Shalita. “There was a spectacular effect on comedones,” he added. This effect received so much attention that the effect the retinoids had on inflammatory lesions “got lost in the shuffle,” according to Dr. Shalita. Today, with the newer retinoids, there’s a re-emphasis on treating inflammatory acne with these drugs.
A look at the clinical results is proof of the dramatic effect topical retinoids have on treating inflammatory acne, said Dr. Shalita.
“A little over a year ago, Dr. James Leyden, Dr. Guy Webster, Dr. Diane Thiboutot, Dr. Ken Washenik and I had the privilege of looking at more than 600 photographs from clinical trials of acne patients. What we found is that all of the topical retinoids had a significant improvement benefit in patients with inflammatory acne,” said Dr. Shalita.
“So the message is that topical retinoids are important for initiating therapy in all but the most severe forms of acne,” advised Dr. Shalita, “and they also should be used for maintenance therapy when patients have improved.”
Antibiotic Resistance
Antibiotic resistance is an issue when treating acne. “If you use benzoyl peroxide in conjunction with antibiotics, you will significantly reduce the decreased sensitivity on the part of the antibiotics.”
A Different Look at Dosing Isotretinoin
Dermatologists have been using this drug for more than 20 years, according to Dr. Shalita. But dermatologists in the United States approach dosing from the standpoint of mg/kg/day. Dr. Shalita proposed a new way of viewing the dosing regimen for isotretinoin — the way European physicians do.
“We should probably look at this as a total cumulative dose rather than mg/kg/day,” he explained.
The reasoning behind this is that you may have some patients who you want to treat for a longer time at a lower dose because you want to manage side effects.
“The critically important thing is to start low,” he said. “Don’t start patients on a dose of 1 mg/kg/day or 2 mg/kg/day,” he stressed.
In addition, avoid prescribing loading doses.
“Some people believe that a loading dose is appropriate, but that’s how you get very severe flare-ups. That’s where you end up with litigation because of aggravation of disease and scarring,” he said.
“You could start low and then gradually increase the dose to 1 mg/kg/day if that’s what your target is,” advised Dr. Shalita. “You can do that over 2 to 3 months and then continue for another 4 months at the full dose. But please don’t start anyone at more than 0.5 mg/kg/day,” he said.
Feel the Heat
Radiofrequency is next in line as a promising therapy for treating active acne.
By Javier Ruiz-Esparza, M.D.
Radiofrequency is Turning up the Heat on Acne
One of the newest modalities under study for this purpose, radiofrequency, harnesses electricity to deliver heat to its target audience — patients who have moderate to severe acne vulgaris.
I’ve been treating many patients with this non-ablative technology, and preliminary results — even in cases of severe nodulo-cystic acne — are most encouraging as you can see in the before and after photo I’ve included here.
How It Works
Non-ablative radiofrequency is delivered through the ThermaCool TC medical device, which is currently in the beta stage of testing. It delivers radiofrequency, which produces uniform, sustained heat in the dermis without an epidermal burn. To accomplish this, pre-cooling, parallel cooling and post-cooling are cryogenically delivered simultaneously.
Patients undergo a 30-minute treatment session under topical anesthesia. The procedure is very well tolerated by these individuals because there’s no residual discomfort and no down time. Many of these patients haven’t been on any other form of therapy, and they’re not receiving concurrent medication. More details on this new treatment alternative will be published shortly.
Dr. Ruiz-Esparza is associate clinical professor at the University of California, San Diego.
Top 10
Here’s a look at the most commonly prescribed acne therapies.
1. Isotretinoin (Accutane)
2. Tretinoin (Retin-A)
3. Tetracycline (in general)
4. Minocycline (Minocin)
5. Clindamycin phosphate (Cleocin)
6. Erythromycin (Benzamycin)
7. Erythromycin (in general)
8. Doxycycline (in general)
9. Benzoyl peroxide (Benzac)
10. Ampicillin (in general)
Source: Sugarman JH, Fleischer AB Jr., Feldman SR. “Off-label prescribing in the treatment of dermatologic disease.”
J Am Acad Dermatol 2002;47(2): 217-223.
Lasers and Acne
A look at recent research with this experimental therapy.
Two recently published studies highlight success in treating acne:
1. Dr. Jennifer Lloyd has published on use with the YAG laser in conjunction with indocyanine green with benefit for acne. According to the American Society for Dermatologic Surgery, Dr. Lloyd applied the ICG dye to a 10-cm x 10-cm area on her patients’ backs. Then, after leaving the dye on for 24 hours and letting the sebaceous glands absorb it, she used the long pulsed diode laser to treat the area. This resulted in a significant decrease in acne pustules.
2. In another study, a 1450-nm pulsed dye laser was used by investigators from the Naval Medical Center in San Diego. According to the ASDS, the laser was used in conjunction with cryogen spray cooling to treat 6-cm x 6-cm areas on the backs of patients. The treatments were performed on 24 patients at 3 to 4 week intervals. When lesions were counted at 6 weeks and 12 weeks, researchers noted a significant decrease in the numbers of lesions.
After the fourth treatment at the 6-week mark, lesions had decreased from 5.43 to 0.43 compared with the control areas, which only dropped from an average lesion count of 5 to 3.86.
Did You Know?
In the United Kingdom, community pharmacists are typically the first healthcare providers patients turn to for acne treatment. Patients next visit general practitioners for help in treating this disease.
Dermatologists in the UK are reserved for high-level referrals for specialized conditions.
Source: Poyner T, Cunliffe B. “Commentary: A UK primary care perspective on treating acne.” BMJ August 2002;475-479.
Jump in Prescriptions
Isotretinoin use is on the rise.
Some fast facts about the tremendous increase in this drug’s prescribing history:
• In the last 8 years, prescriptions for isotretinoin (Accutane) have increased by 250% in the United States.
• Over an 18-year period — from 1982 to 2000 — retail pharmacies dispensed 19.8 million prescriptions for this popular acne therapy.
• Between 1992 and 2000, the number of prescriptions for isotretinoin increased 2.5-fold to nearly 2 million.
• Between 1993 and 2000, the use of isotretinoin to treat severe acne declined 63% to 46%.
• During the same time, treatment with isotretinoin for mild to moderate acne increased from 31% to 49%.
• Patients receiving isotretinoin were men between the ages of 15 and 19 in 63% of cases and women between ages 15 and 24 in 51% of cases.
Source: Wysowski DK, Swann J, Vega A. “Use of isotretinoin (Accutane) in the United States: Rapid Increase from 1992 to 2000.” J Am Acad Dermatol 2002;46:505-509.
Déjà vu
An update from the summer AAD meeting.
We’ve been here before; it’s déjà vu all over again. That’s how well-known acne treatment expert Alan Shalita, M.D., summed up the latest in acne therapies when he spoke at this summer’s American Academy of Dermatology meeting in New York City.
Dr. Shalita, who is professor and chair of dermatology at SUNY-Downstate in Brooklyn, NY, made reference to the recent use of phototherapy to treat acne and likened this approach to one he remembers from his early days of practice.
“When I started my residency, it was very common to use hot quartz for treating acne,” said Dr. Shalita during his AAD plenary session presentation. “Many of us thought that was a lot of voodoo, but it’s a fact that about 70% of acne patients are better in the summer. There’s also a camouflage effect from tanning, and you do dry up inflammatory lesions — however UV light is comedogenic and carcinogenic.”
Porphyrins and P. Acnes
About 28 years ago, Dr. Shalita and a colleague described the porphyrins in Propionibacterium acnes while working at Columbia University.
“We easily detected these using a Wood’s light and fluorescence,” explained Dr. Shalita. “But for some reason, we never thought of shining a light on these porphyrins to aggravate them.”
According to Dr. Shalita, research has shown that the porphyrins in P. acnes are much more sensitive to 410-nm or 420-nm light than any other wavelength. This therapeutic approach eradicates
P. acnes, assuming you have a critical mass of P. acnes to start with, said Dr. Shalita. “You can see that in most patients the density of the acne decreased very dramatically,” he added.
In addition, this wavelength has a significant effect on intracellular lesion models and interleukin — all of which are involved in the pathogenesis of acne.
Topical Retinoids for Inflammatory Acne
Using topical retinoids to treat inflammatory acne isn’t a new concept, said Dr. Shalita. It’s actually an old concept that’s now receiving increasing attention. As you know, the microcomedo is the precursor of all other acne lesions, and it’s best treated with retinoids.
When Dr. Shalita was a resident at the Skin and Cancer Unit at New York University, he and colleagues demonstrated that most comedones and inflammatory lesions dramatically improved when topical retinoids were applied.
“At this time, we used tretinoin swabs, which were way too irritating for the average practitioner to use,” explained Dr. Shalita. “There was a spectacular effect on comedones,” he added. This effect received so much attention that the effect the retinoids had on inflammatory lesions “got lost in the shuffle,” according to Dr. Shalita. Today, with the newer retinoids, there’s a re-emphasis on treating inflammatory acne with these drugs.
A look at the clinical results is proof of the dramatic effect topical retinoids have on treating inflammatory acne, said Dr. Shalita.
“A little over a year ago, Dr. James Leyden, Dr. Guy Webster, Dr. Diane Thiboutot, Dr. Ken Washenik and I had the privilege of looking at more than 600 photographs from clinical trials of acne patients. What we found is that all of the topical retinoids had a significant improvement benefit in patients with inflammatory acne,” said Dr. Shalita.
“So the message is that topical retinoids are important for initiating therapy in all but the most severe forms of acne,” advised Dr. Shalita, “and they also should be used for maintenance therapy when patients have improved.”
Antibiotic Resistance
Antibiotic resistance is an issue when treating acne. “If you use benzoyl peroxide in conjunction with antibiotics, you will significantly reduce the decreased sensitivity on the part of the antibiotics.”
A Different Look at Dosing Isotretinoin
Dermatologists have been using this drug for more than 20 years, according to Dr. Shalita. But dermatologists in the United States approach dosing from the standpoint of mg/kg/day. Dr. Shalita proposed a new way of viewing the dosing regimen for isotretinoin — the way European physicians do.
“We should probably look at this as a total cumulative dose rather than mg/kg/day,” he explained.
The reasoning behind this is that you may have some patients who you want to treat for a longer time at a lower dose because you want to manage side effects.
“The critically important thing is to start low,” he said. “Don’t start patients on a dose of 1 mg/kg/day or 2 mg/kg/day,” he stressed.
In addition, avoid prescribing loading doses.
“Some people believe that a loading dose is appropriate, but that’s how you get very severe flare-ups. That’s where you end up with litigation because of aggravation of disease and scarring,” he said.
“You could start low and then gradually increase the dose to 1 mg/kg/day if that’s what your target is,” advised Dr. Shalita. “You can do that over 2 to 3 months and then continue for another 4 months at the full dose. But please don’t start anyone at more than 0.5 mg/kg/day,” he said.
Feel the Heat
Radiofrequency is next in line as a promising therapy for treating active acne.
By Javier Ruiz-Esparza, M.D.
Radiofrequency is Turning up the Heat on Acne
One of the newest modalities under study for this purpose, radiofrequency, harnesses electricity to deliver heat to its target audience — patients who have moderate to severe acne vulgaris.
I’ve been treating many patients with this non-ablative technology, and preliminary results — even in cases of severe nodulo-cystic acne — are most encouraging as you can see in the before and after photo I’ve included here.
How It Works
Non-ablative radiofrequency is delivered through the ThermaCool TC medical device, which is currently in the beta stage of testing. It delivers radiofrequency, which produces uniform, sustained heat in the dermis without an epidermal burn. To accomplish this, pre-cooling, parallel cooling and post-cooling are cryogenically delivered simultaneously.
Patients undergo a 30-minute treatment session under topical anesthesia. The procedure is very well tolerated by these individuals because there’s no residual discomfort and no down time. Many of these patients haven’t been on any other form of therapy, and they’re not receiving concurrent medication. More details on this new treatment alternative will be published shortly.
Dr. Ruiz-Esparza is associate clinical professor at the University of California, San Diego.
Top 10
Here’s a look at the most commonly prescribed acne therapies.
1. Isotretinoin (Accutane)
2. Tretinoin (Retin-A)
3. Tetracycline (in general)
4. Minocycline (Minocin)
5. Clindamycin phosphate (Cleocin)
6. Erythromycin (Benzamycin)
7. Erythromycin (in general)
8. Doxycycline (in general)
9. Benzoyl peroxide (Benzac)
10. Ampicillin (in general)
Source: Sugarman JH, Fleischer AB Jr., Feldman SR. “Off-label prescribing in the treatment of dermatologic disease.”
J Am Acad Dermatol 2002;47(2): 217-223.
Lasers and Acne
A look at recent research with this experimental therapy.
Two recently published studies highlight success in treating acne:
1. Dr. Jennifer Lloyd has published on use with the YAG laser in conjunction with indocyanine green with benefit for acne. According to the American Society for Dermatologic Surgery, Dr. Lloyd applied the ICG dye to a 10-cm x 10-cm area on her patients’ backs. Then, after leaving the dye on for 24 hours and letting the sebaceous glands absorb it, she used the long pulsed diode laser to treat the area. This resulted in a significant decrease in acne pustules.
2. In another study, a 1450-nm pulsed dye laser was used by investigators from the Naval Medical Center in San Diego. According to the ASDS, the laser was used in conjunction with cryogen spray cooling to treat 6-cm x 6-cm areas on the backs of patients. The treatments were performed on 24 patients at 3 to 4 week intervals. When lesions were counted at 6 weeks and 12 weeks, researchers noted a significant decrease in the numbers of lesions.
After the fourth treatment at the 6-week mark, lesions had decreased from 5.43 to 0.43 compared with the control areas, which only dropped from an average lesion count of 5 to 3.86.
Did You Know?
In the United Kingdom, community pharmacists are typically the first healthcare providers patients turn to for acne treatment. Patients next visit general practitioners for help in treating this disease.
Dermatologists in the UK are reserved for high-level referrals for specialized conditions.
Source: Poyner T, Cunliffe B. “Commentary: A UK primary care perspective on treating acne.” BMJ August 2002;475-479.
Jump in Prescriptions
Isotretinoin use is on the rise.
Some fast facts about the tremendous increase in this drug’s prescribing history:
• In the last 8 years, prescriptions for isotretinoin (Accutane) have increased by 250% in the United States.
• Over an 18-year period — from 1982 to 2000 — retail pharmacies dispensed 19.8 million prescriptions for this popular acne therapy.
• Between 1992 and 2000, the number of prescriptions for isotretinoin increased 2.5-fold to nearly 2 million.
• Between 1993 and 2000, the use of isotretinoin to treat severe acne declined 63% to 46%.
• During the same time, treatment with isotretinoin for mild to moderate acne increased from 31% to 49%.
• Patients receiving isotretinoin were men between the ages of 15 and 19 in 63% of cases and women between ages 15 and 24 in 51% of cases.
Source: Wysowski DK, Swann J, Vega A. “Use of isotretinoin (Accutane) in the United States: Rapid Increase from 1992 to 2000.” J Am Acad Dermatol 2002;46:505-509.
Déjà vu
An update from the summer AAD meeting.
We’ve been here before; it’s déjà vu all over again. That’s how well-known acne treatment expert Alan Shalita, M.D., summed up the latest in acne therapies when he spoke at this summer’s American Academy of Dermatology meeting in New York City.
Dr. Shalita, who is professor and chair of dermatology at SUNY-Downstate in Brooklyn, NY, made reference to the recent use of phototherapy to treat acne and likened this approach to one he remembers from his early days of practice.
“When I started my residency, it was very common to use hot quartz for treating acne,” said Dr. Shalita during his AAD plenary session presentation. “Many of us thought that was a lot of voodoo, but it’s a fact that about 70% of acne patients are better in the summer. There’s also a camouflage effect from tanning, and you do dry up inflammatory lesions — however UV light is comedogenic and carcinogenic.”
Porphyrins and P. Acnes
About 28 years ago, Dr. Shalita and a colleague described the porphyrins in Propionibacterium acnes while working at Columbia University.
“We easily detected these using a Wood’s light and fluorescence,” explained Dr. Shalita. “But for some reason, we never thought of shining a light on these porphyrins to aggravate them.”
According to Dr. Shalita, research has shown that the porphyrins in P. acnes are much more sensitive to 410-nm or 420-nm light than any other wavelength. This therapeutic approach eradicates
P. acnes, assuming you have a critical mass of P. acnes to start with, said Dr. Shalita. “You can see that in most patients the density of the acne decreased very dramatically,” he added.
In addition, this wavelength has a significant effect on intracellular lesion models and interleukin — all of which are involved in the pathogenesis of acne.
Topical Retinoids for Inflammatory Acne
Using topical retinoids to treat inflammatory acne isn’t a new concept, said Dr. Shalita. It’s actually an old concept that’s now receiving increasing attention. As you know, the microcomedo is the precursor of all other acne lesions, and it’s best treated with retinoids.
When Dr. Shalita was a resident at the Skin and Cancer Unit at New York University, he and colleagues demonstrated that most comedones and inflammatory lesions dramatically improved when topical retinoids were applied.
“At this time, we used tretinoin swabs, which were way too irritating for the average practitioner to use,” explained Dr. Shalita. “There was a spectacular effect on comedones,” he added. This effect received so much attention that the effect the retinoids had on inflammatory lesions “got lost in the shuffle,” according to Dr. Shalita. Today, with the newer retinoids, there’s a re-emphasis on treating inflammatory acne with these drugs.
A look at the clinical results is proof of the dramatic effect topical retinoids have on treating inflammatory acne, said Dr. Shalita.
“A little over a year ago, Dr. James Leyden, Dr. Guy Webster, Dr. Diane Thiboutot, Dr. Ken Washenik and I had the privilege of looking at more than 600 photographs from clinical trials of acne patients. What we found is that all of the topical retinoids had a significant improvement benefit in patients with inflammatory acne,” said Dr. Shalita.
“So the message is that topical retinoids are important for initiating therapy in all but the most severe forms of acne,” advised Dr. Shalita, “and they also should be used for maintenance therapy when patients have improved.”
Antibiotic Resistance
Antibiotic resistance is an issue when treating acne. “If you use benzoyl peroxide in conjunction with antibiotics, you will significantly reduce the decreased sensitivity on the part of the antibiotics.”
A Different Look at Dosing Isotretinoin
Dermatologists have been using this drug for more than 20 years, according to Dr. Shalita. But dermatologists in the United States approach dosing from the standpoint of mg/kg/day. Dr. Shalita proposed a new way of viewing the dosing regimen for isotretinoin — the way European physicians do.
“We should probably look at this as a total cumulative dose rather than mg/kg/day,” he explained.
The reasoning behind this is that you may have some patients who you want to treat for a longer time at a lower dose because you want to manage side effects.
“The critically important thing is to start low,” he said. “Don’t start patients on a dose of 1 mg/kg/day or 2 mg/kg/day,” he stressed.
In addition, avoid prescribing loading doses.
“Some people believe that a loading dose is appropriate, but that’s how you get very severe flare-ups. That’s where you end up with litigation because of aggravation of disease and scarring,” he said.
“You could start low and then gradually increase the dose to 1 mg/kg/day if that’s what your target is,” advised Dr. Shalita. “You can do that over 2 to 3 months and then continue for another 4 months at the full dose. But please don’t start anyone at more than 0.5 mg/kg/day,” he said.
Feel the Heat
Radiofrequency is next in line as a promising therapy for treating active acne.
By Javier Ruiz-Esparza, M.D.
Radiofrequency is Turning up the Heat on Acne
One of the newest modalities under study for this purpose, radiofrequency, harnesses electricity to deliver heat to its target audience — patients who have moderate to severe acne vulgaris.
I’ve been treating many patients with this non-ablative technology, and preliminary results — even in cases of severe nodulo-cystic acne — are most encouraging as you can see in the before and after photo I’ve included here.
How It Works
Non-ablative radiofrequency is delivered through the ThermaCool TC medical device, which is currently in the beta stage of testing. It delivers radiofrequency, which produces uniform, sustained heat in the dermis without an epidermal burn. To accomplish this, pre-cooling, parallel cooling and post-cooling are cryogenically delivered simultaneously.
Patients undergo a 30-minute treatment session under topical anesthesia. The procedure is very well tolerated by these individuals because there’s no residual discomfort and no down time. Many of these patients haven’t been on any other form of therapy, and they’re not receiving concurrent medication. More details on this new treatment alternative will be published shortly.
Dr. Ruiz-Esparza is associate clinical professor at the University of California, San Diego.
Top 10
Here’s a look at the most commonly prescribed acne therapies.
1. Isotretinoin (Accutane)
2. Tretinoin (Retin-A)
3. Tetracycline (in general)
4. Minocycline (Minocin)
5. Clindamycin phosphate (Cleocin)
6. Erythromycin (Benzamycin)
7. Erythromycin (in general)
8. Doxycycline (in general)
9. Benzoyl peroxide (Benzac)
10. Ampicillin (in general)
Source: Sugarman JH, Fleischer AB Jr., Feldman SR. “Off-label prescribing in the treatment of dermatologic disease.”
J Am Acad Dermatol 2002;47(2): 217-223.
Lasers and Acne
A look at recent research with this experimental therapy.
Two recently published studies highlight success in treating acne:
1. Dr. Jennifer Lloyd has published on use with the YAG laser in conjunction with indocyanine green with benefit for acne. According to the American Society for Dermatologic Surgery, Dr. Lloyd applied the ICG dye to a 10-cm x 10-cm area on her patients’ backs. Then, after leaving the dye on for 24 hours and letting the sebaceous glands absorb it, she used the long pulsed diode laser to treat the area. This resulted in a significant decrease in acne pustules.
2. In another study, a 1450-nm pulsed dye laser was used by investigators from the Naval Medical Center in San Diego. According to the ASDS, the laser was used in conjunction with cryogen spray cooling to treat 6-cm x 6-cm areas on the backs of patients. The treatments were performed on 24 patients at 3 to 4 week intervals. When lesions were counted at 6 weeks and 12 weeks, researchers noted a significant decrease in the numbers of lesions.
After the fourth treatment at the 6-week mark, lesions had decreased from 5.43 to 0.43 compared with the control areas, which only dropped from an average lesion count of 5 to 3.86.
Did You Know?
In the United Kingdom, community pharmacists are typically the first healthcare providers patients turn to for acne treatment. Patients next visit general practitioners for help in treating this disease.
Dermatologists in the UK are reserved for high-level referrals for specialized conditions.
Source: Poyner T, Cunliffe B. “Commentary: A UK primary care perspective on treating acne.” BMJ August 2002;475-479.
Jump in Prescriptions
Isotretinoin use is on the rise.
Some fast facts about the tremendous increase in this drug’s prescribing history:
• In the last 8 years, prescriptions for isotretinoin (Accutane) have increased by 250% in the United States.
• Over an 18-year period — from 1982 to 2000 — retail pharmacies dispensed 19.8 million prescriptions for this popular acne therapy.
• Between 1992 and 2000, the number of prescriptions for isotretinoin increased 2.5-fold to nearly 2 million.
• Between 1993 and 2000, the use of isotretinoin to treat severe acne declined 63% to 46%.
• During the same time, treatment with isotretinoin for mild to moderate acne increased from 31% to 49%.
• Patients receiving isotretinoin were men between the ages of 15 and 19 in 63% of cases and women between ages 15 and 24 in 51% of cases.
Source: Wysowski DK, Swann J, Vega A. “Use of isotretinoin (Accutane) in the United States: Rapid Increase from 1992 to 2000.” J Am Acad Dermatol 2002;46:505-509.
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