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Low‐dose isotretinoin versus minocycline in the treatment of rosacea
Author(s) -
Shemer Avner,
Gupta Aditya K.,
Kassem Riad,
Sharon Nechama,
Quinlan Emma M.,
Galili Eran
Publication year - 2021
Publication title -
dermatologic therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.595
H-Index - 68
eISSN - 1529-8019
pISSN - 1396-0296
DOI - 10.1111/dth.14986
Subject(s) - rosacea , isotretinoin , medicine , papulopustular , minocycline , dermatology , acne , antibiotics , gastroenterology , microbiology and biotechnology , biology
Rosacea is a common inflammatory facial skin condition affecting the adult population. Its papulopustular subtype is mainly treated pharmacologically by topical and oral antibiotics. For severe or antibiotics‐recalcitrant disease, daily low‐dose isotretinoin has also been reported to be effective. However, no previous study has assessed the efficacy of once‐weekly administered isotretinoin for papulopustular rosacea. For this purpose, a retrospective comparative study was conducted. For severe rosacea, 40 mg/week isotretinoin (24 patients) was administered. For mild to moderate rosacea, once‐weekly 20 mg/week isotretinoin (28 patients) was compared with 100 mg/day minocycline (24 patients). Treatment courses lasted 4 to 7 months. Forty milligrams per week isotretinoin was highly effective for severe rosacea, achieving complete response (over 90% improvement) in 62.5% of patients and partial response (50%‐90% improvement) in additional 29.2% of patients. Twenty milligrams per week isotretinoin and hundred milligrams per day minocycline showed comparable efficacy for mild to moderate rosacea (complete response of 10.7% vs 8.3% and partial response of 28.6% vs 33.3%, respectively). This study demonstrates that that the use of a weekly low‐dose isotretinoin is an effective treatment for papulopustular rosacea, including among patients with severe disease.