Managing Moderate to Severe Teen Acne with Isotretinoin (Accutane) in Katy and Houston, Texas
Acne is one of the most common skin conditions affecting teenagers, but for some patients, acne goes beyond mild breakouts and becomes painful, persistent, and emotionally distressing. At Reena Jogi, MD, we frequently treat teens with moderate to severe acne using evidence-based therapies, including isotretinoin (Accutane), when appropriate.
This case highlights the safe and effective management of cystic and inflammatory acne in a teenage male patient receiving isotretinoin therapy in the Katy and Houston, Texas area.
Patient Presentation
A 16-year-old male presented as a new patient for evaluation of moderate acne involving the face. His acne consisted of a combination of comedonal papules, inflammatory papules, pustules, and deeper cystic lesions, which are known to increase the risk of permanent acne scarring if left untreated.
The patient was accompanied by his father and had already begun isotretinoin therapy under the care of another provider. He sought continued acne management and Accutane monitoring with our dermatology team.
Clinical Examination
A focused dermatologic examination was performed, including evaluation of the face, scalp, and head, using a dermatoscope to assess lesion morphology. The patient appeared well-developed and well-nourished, alert, and in no acute distress.
Clinical findings were consistent with moderate inflammatory and comedonal acne. Associated side effects of treatment included xerosis (dry skin) and cheilitis (lip dryness)—both common and expected with isotretinoin therapy.
Acne Treatment Plan: Continuing Isotretinoin
Given the severity of acne and the patient’s good tolerance of treatment so far, the decision was made to continue isotretinoin (Accutane) with careful monitoring.
Medication: Isotretinoin 40 mg capsules
Dose: 120 mg daily (combination dosing as discussed with patient and parent)
Goal: Achieve a cumulative dose of approximately 220 mg/kg
Monitoring: Monthly follow-ups with blood work
The patient reported no major side effects other than dryness and denied headaches, mood changes, muscle aches, nosebleeds, or vision changes.
Isotretinoin Counseling and Safety Monitoring
At Reena Jogi, MD, patient education is a cornerstone of Accutane therapy. Extensive counseling was provided to both the patient and his father, covering:
Monthly lab monitoring
Avoiding blood donation during therapy
Avoiding sharing medication
Not driving at night if vision is affected
Avoiding elective procedures for 6 months after completion
Potential side effects—including dry skin, dry lips, joint aches, temporary hair shedding, mood changes, and rare neurologic symptoms—were reviewed in detail. The patient and parent demonstrated clear understanding and agreed to ongoing monitoring.
Managing Accutane Side Effects
To manage treatment-related dryness, the following supportive care was recommended:
For Cheilitis (Dry Lips):
Frequent application of Vaseline or Aquaphor
Dr. Dan’s Cortibalm as needed
For Xerosis (Dry Skin):
Liberal use of CeraVe or Cetaphil moisturizers
Gentle, non-comedogenic skincare products
Sun Protection:
Daily broad-spectrum sunscreen SPF 30+, such as EltaMD UV Clear
Acne Skin Care Education
Patients on isotretinoin benefit from simplified skincare routines. Recommended cleansers included:
Cetaphil Oil Control
CeraVe Foaming Cleanser
SkinMedica AHA/BHA Cleanser
Neutrogena Oil-Free Acne Wash
Education emphasized that acne is a chronic condition, improvement takes time, and early treatment helps prevent permanent acne scarring and long-term emotional impact.
Follow-Up and Ongoing Care
The patient will return in one month for continued isotretinoin monitoring and acne evaluation. With consistent follow-up and adherence to therapy, most patients experience dramatic improvement in both active acne and skin texture.
Expert Acne Care in Katy and Houston, Texas
If your teenager is struggling with moderate to severe acne, Reena Jogi, MD provides personalized, medically supervised Accutane treatment in Katy and Houston, Texas. Our dermatology team prioritizes safety, education, and long-term skin health.
