Isotretinoin is the treatment of choice for severe nodulocystic acne. It represents the sole agent that effectively addresses all of the pathophysiological factors in the production of acne. Dosing recommendations are based on European trials that included patients with nonacne skin disease, which requires higher doses of Isotretinoin for clearance. In this article, the authors relate their extensive experience with dosing regimens for acne as well as discuss recommendations for length of therapy.

Isotretinoin is the treatment of choice for severe nodulocystic acne. It represents the sole agent that effectively addresses all of the pathophysiological factors in the production of acne.