Prevalence and associated risk factors of acne relapse among Saudi acne vulgaris patients using isotretinoin

BACKGROUND: Acne vulgaris is a self-limiting condition that may affect the patients quality of life. The most efficacious treatment of choice for acne is isotretinoin. However, adverse effects and relapse of acne after completing an isotretinoin course pose major hurdles for treatment compliance and adherence. METHOD: The authors conducted a cross-sectional study using a self-administered questionnaire. The prevalence and risk factors associated with the relapse of acne following isotretinoin use among Saudi patients were assessed. In addition, the reasons for discontinuing treatment, extent of awareness about isotretinoin use-associated teratogenicity, side effects such as liver enzymes impairments, dry mouth, skin, eyes, and the number of people using isotretinoin without a prescription were determined. RESULTS: Four hundred and twenty seven acne vulgaris patients (mean age: 25.0 years, female: 83%) were included in this study. Of the 57% subjects who used isotretinoin, 45.12% patients showed relapse. The daily dose of oral isotretinoin of 20 and 40 mg/day was taken by 80% in both group of patients, and the mean duration of isotretinoin use was 7.15(±4.5) months. Those patients who were taking higher doses of oral isotretinoin reported having more relapses. Although a majority of patients received the medication through prescription, unfortunately, they were not aware of relapse and side effects. CONCLUSION: Almost half of the patients showed relapse of acne after using isotretinoin. A lack of understanding regarding relapse and side effects indicates a need to improve public and professional awareness of isotretinoin.