Dear Doctors, I have had excessive production of sebum (seborrhea) from my nose pores since I was 16 years old. Since 5 years ago I get seborrheic dermatitis on my nose. My dermatologist prescribed 40mg/day Isotretinoin to treat the seborrhea - I weigh 80kg I read about low dose regimes of 2.5mg per day to control seborrhea but it is long term treatment. For seborrhea would 40mg/day and reaching target 120mg/kg dosage have more chance of permanent sebum reduction than the low dose regime?
Low Dose Accutane for Seborrhea
Doctor Answers 2
Dosing for Accutane
Dosages for Accutane depend on several factors, like you suggested. My assumption is that your prescribing physician may be starting you on a relatively high dose and then will lower it over the course of a few months to a year for more of a maintenance regimen. This is what I normally do too to treat what you have. I start patients on 20mg a day (40mg is too high to start with in Vegas climate) for usually 3-4 months, then I lower it to 20mg a day for about 3 days per week, and then lower it again a few months later to 1 20mg pill 1x per week for long term maintenance and control. My assumption is that this is what your physician is doing - or something similar - but you should ask him/her. If you have questions about your dosing or alternative methods, always ask your physician!
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Lo Dose Isotretinoin vs the Full Court Press
Lo dose isotretinoin works very well for seborrhea and desultory acne breakouts. A 40mg/d dosing is more along the lines of the Full Court Press, where we are looking at a 5-7m course of treatment as a definitive therapy. Lo dose is adjusted by the patient as needed. I usually dose at 10mg Mondays and Thursdays.