Isotretinoin for treatment of acne

The Australasian College of Dermatologists (ACD) has this week released a position statement on isotretinoin for the treatment of acne.

In Australia, isotretinoin can be prescribed only by specialist dermatologists and physicians in accordance with federal, state and territory legislation. Patients undergoing treatment with isotretinoin may be concurrently receiving care from general practitioners or allied healthcare professionals for related or unrelated conditions.

Dr Jo-Ann See, a dermatologist with the ACD, who was involved with the development of the ACD position statement, said: “Isotretinoin is an oral retinoid prescribed for the treatment of severe, persistent or scarring acne. With over 30 years in clinical use, isotretinoin is accepted as the most effective treatment for severe acne, offering long term remission for the majority of patients.”

The position statement is aimed at providing guidance to primary or allied healthcare professionals and pharmacists wanting to know more about isotretinoin, or who have patients undergoing treatment with this medication, to help inform their patient management strategies within the primary care or community-based setting.

“The ACD position statement provides advice to all doctors on use in women of child-bearing potential, other contraindications, precautions, dosage, adverse effects and mental health,” Dr See said.

Acne is the most common skin disease, affecting 85 per cent of people aged 15 to 24 years old. Adult acne is acne that starts in the early 20s in individuals who may not previously have had a problem with acne. It can occur in men, but is more frequently seen in women.

“Currently, there is no universally accepted grading system for acne,” Dr See said. “When treating acne, dermatologists look at types of acne lesions, disease severity, anatomical sites and scarring, and use consistently to guide disease management planning and assess treatment response.”

Isotretinoin is subsided under the PBS when prescribed for the treatment of severe cystic acne that is unresponsive to conventional therapies. Dermatologists can prescribe isotretinoin for indications other than that specified by the PBS. These prescriptions are ‘off-label’ and are not eligible for PBS reimbursement.