Why Does Acne Relapse After Accutane Treatment?

Accutane is most effective when it is given at an average dose of 1 mg/kg per day for 6 months.  Low dose Accutane like 20 mg per day for 4 months usually clears the acne well but is much more likely to relapse.  So the total dose during treatment is one potential cause of relapse after Accutane.

Even if given at the right dose, there is a certain percentage of patients that will relapse, approximately 20%.  Some will need a repeat course of Accutane and some may not respond at all. 

Other factors that may make a relapse more likely include hormonal abnormalities, like polycystic ovary syndrome, where there is an excess of androgens that lead to acne break outs.  Accutane is less effective in patients with hormonal abnormalities.