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Low Dose Accutane for Seborrhea

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?

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!

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.

Barry Resnik, MD
Miami Dermatologist
5.0 out of 5 stars 1 review

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