Case Report: 16-Year-Old Male on Isotretinoin (Accutane) for Persistent Acne – Follow-Up Visit
At Reena Jogi MD, Village Dermatology in Katy and Houston, Texas, we frequently manage challenging cases of acne in teenage patients who have not responded adequately to topical or oral therapies. This case highlights the ongoing treatment and monitoring of a 16-year-old male currently undergoing isotretinoin (Accutane) therapy for moderate to severe acne.
Patient Background
The patient was initially evaluated on September 23, 2025, for acne affecting the face. After considering previous treatment responses and the persistence of inflammatory lesions, the patient began isotretinoin 40 mg daily (taken as one capsule twice daily). He returned for follow-up after four months of treatment for further evaluation and management.
Clinical Findings
On examination, the patient had inflammatory papules, pustules, and comedonal papules distributed across the face. No new cystic lesions or scarring were noted. The patient reported good overall tolerance to isotretinoin, with only mild dryness and occasional nosebleeds, which are common side effects of Accutane.
Treatment Plan and Ongoing Management
The patient was advised to continue isotretinoin 40 mg daily, with monthly blood work and regular follow-up visits to monitor side effects and treatment response.
He was also counseled on comprehensive acne skin care and medication safety, including:
Use of non-comedogenic cleansers, moisturizers, and sunscreen (SPF 30+)
Avoiding blood donation during treatment
Not sharing medication with others
Avoiding elective surgery for six months post-treatment
Monitoring for side effects such as dryness, muscle aches, headaches, or mood changes
For nasal dryness and nosebleeds, the patient was advised to use saline nasal mist multiple times daily. If the symptom worsens, he will contact the office for additional care.
Isotretinoin Monitoring and Safety
Patients on isotretinoin are closely monitored for safety, given the medication’s high-risk status (Z79.899). Regular laboratory tests are conducted to assess liver function and lipid levels.
The goal cumulative dose is typically 120–220 mg/kg, achieved over several months of consistent therapy.
The patient was confirmed in the iPLEDGE program, and his prescription was renewed for another month of treatment. He will follow up in six weeks for re-evaluation.
Discussion
This case illustrates the importance of close follow-up and patient education in managing acne with isotretinoin. While this medication is highly effective—often leading to long-term remission—it requires careful monitoring and open communication between patient and provider to minimize risks.
At Reena Jogi MD, Village Dermatology, we specialize in acne management for teens and adults in Katy and Houston, Texas, using the most effective evidence-based treatments, including Accutane (isotretinoin). Our dermatologists provide individualized care to ensure safety and success throughout the treatment process.
