Long Term Extra Low Dose Accutane

Written by on January 17, 2006 in Accutane and Roaccutane with 4 Comments

Another promising sounding paper on the use of very low dose accutane for hard to treat rosacea. Dr. Hofer is analysing doses of around 3mg to 8mg a day for his `continuous microdose’ regime.

Interestingly he is suggesting that it is common for symptoms to relapse after accutane treatment is ceased – unlike the typical result when treating acne with accutane.

Some interesting extracts from the paper are below. If you would like to read a full copy of this short paper (called a correspondence), please email me or leave a comment below.

Continuous ‘microdose’ isotretinoin in adult recalcitrant rosacea.

Clinical & Experimental Dermatology, Volume 29 Page 204 – March 2004, Viewpoints in dermatology. Correspondence, T. Hofer, Private dermatological practice, Winkelriedstrasse 10, CH-5430, Wettingen, Switzerland.

Low-dose isotretinoin is a well-known treatment in severe cases of rosacea. In 2000, Palmer et al. showed that continuous microdose isotretinoin (CMI) treatment (0.04-0.11 mg/kg daily) was sufficient to control adult relapsing acne, but they mentioned that this is an unlicensed method adminstration.

In 1994, Finaly and Khan introduced the Dermatology Life Quality Index (DLQI), a questionnaire for routine clinical use. This test measures the extent of the disability caused by skin diseases. Ten questions cover symptoms and feelings, daily activites, leisure, personal relationships and treatment.

The DLQI, used here for the first time to measure the degree of disability caused by rosacea, uncovers a very high degree of psychological distress as revealed by high scores on questions concerning embarrassment and self-consciousness. Rosacea is very symptomatic and the usual treatment (to hide it) causes many problems.

However, the effectiveness of CMI is clearly demonstrated by the low mean post-treatment DLQI score in group 1 (those on CMI as a maintenance).

Rosacea, in contrast with acne, is a persistent dermatosis that tends to relapse if isotretinoin is stopped, independent of the final cumulative dose. CMI offers a long-term treatment option for a selected group with recalcitrant rosacea where the teratogenicity of retinoids is not an important consideration. CMI prevents patients with recalcitrant rosacea from psychologically stressful relapses, and is clinically well tolerated. Overall, CMI could certainly be considered a preferable alternative to repeat course of systemic antibiotics. To the end, the DLQI is especially valuable in demonstrating quality of life benefits that can result even from an unlicensed, unconventional treatment.

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About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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4 Reader Comments

  1. ANNE says:

    Need to read the full article

  2. Dave says:

    Hi

    Please could I get a copy of the full article?

    Thanks

  3. Jonh says:

    Interestingly he is suggesting that it is common for symptoms to relapse after accutane treatment is ceased – unlike the typical result when treating acne with accutane.
    wtf did i just read

  4. ARG says:

    Can I please get a copy of this article ?

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