Case Report: 13-Year-Old Female on Isotretinoin (Accutane) for Persistent Acne – Follow-Up Visit
At Reena Jogi MD, Village Dermatology in Katy and Houston, Texas, our dermatology team specializes in managing acne in teens who experience persistent breakouts despite standard therapies. This case highlights a 13-year-old female returning for follow-up evaluation while undergoing isotretinoin (Accutane) treatment for moderate to severe acne.
Patient Background
The patient was initially evaluated on September 26, 2025, for acne affecting the face. She was started on isotretinoin 40 mg daily, taken with fatty foods to improve absorption. At this visit, she returns for her focused one-month follow-up to assess her progress and tolerance of treatment.
Clinical Examination
The patient appeared well-developed, well-nourished, and in no distress. She was alert and oriented, with a normal mood and affect. On skin exam, she exhibited comedonal and inflammatory papules and pustules distributed across the face. No new nodules or cysts were identified.
Assessment and Plan
The patient is tolerating isotretinoin well, experiencing only mild dryness, a common and manageable side effect. Given her mild flare-ups this past month, her isotretinoin dose was increased to 80 mg daily to enhance therapeutic efficacy.
She was counseled extensively on Accutane safety precautions, including the importance of not becoming pregnant, not donating blood, and not sharing medication. A urine pregnancy test (UPT) will be submitted via Klara for iPLEDGE confirmation prior to her next prescription.
Patient Counseling and Education
The patient received thorough education on acne skin care and medication safety:
Use non-comedogenic cleansers, moisturizers, and sunscreens (SPF 30+)
Expect visible improvement over 2–3 months, with potential 60–80% reduction in acne lesions
Contact the clinic if acne worsens or new scarring develops
Isotretinoin Monitoring and Safety
Because isotretinoin is considered a high-risk medication (Z79.899), the patient is enrolled in the iPLEDGE program and receives monthly monitoring. Routine blood tests will continue to evaluate her lipid profile and liver function throughout therapy.
The treatment protocol will continue until she reaches a cumulative dose of approximately 220 mg/kg, the standard therapeutic goal for isotretinoin therapy.
Current prescription:
Isotretinoin 40 mg capsules
Take one capsule twice daily (80 mg total per day)
Quantity: 60 capsules
Discussion
This case demonstrates the careful balance between efficacy and safety when managing teen acne with isotretinoin. With close supervision, most patients achieve long-term clearance and improved confidence without significant complications.
At Reena Jogi MD, Village Dermatology, we pride ourselves on providing individualized acne treatment for adolescents in Katy and Houston, Texas. Our approach includes clinical monitoring, patient education, and compassionate support to ensure both safety and success during Accutane therapy.
