Isotretinoin in the treatment of acne: histologic changes, sebum production, and clinical observations

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Abstract
Isotretinoin was administered orally for 16 wk, in a dosage of 1 mg/kg per day, to 7 men with severe acne. A 36.2% reduction of nodulocystic lesions was observed at the conclusion of treatment and a 47.2% reduction was noted at the end of a 16-wk follow-up period. There was an 88.4% decrease in sebum production and a marked reduction histologically in sebaceous gland size after 16 wk of treatment, with a partial recovery or glandular activity at 32 wk. The failure to observe a more striking overall response clinically resulted primarily from 2 of the 7 patients showing worsening or no improvement of their disease, despite profound sebaceous gland inhibition. The marked sebostatic effect of isotretinoin may not be the sole explantation for its mechanism of action in reducing the severity of acne.