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. 2024 Apr 23;16(4):e58840. doi: 10.7759/cureus.58840

Table 2. Dermatologists’ responses regarding starting isotretinoin for acne treatment (n=147).

N, frequency number; %, percentage

The dimension Item N(%)
The number of patients who had an isotretinoin prescription in the last year (2022) 0–10 20 (13.60)
10–50 33 (22.45)
50–100 53 (36.06)
More than 100 41 (27.89)
Important reasons for starting treatment with isotretinoin Treating patients with skin disorders 5 (03.40)
Failure to respond to previous treatments 22 (14.97)
An indicator of resistant nodular acne 45 (30.61)
According to my experience, I prescribe it to people who suffer from severe acne 58 (39.45)
Patient request 5 (03.40)
Psychological complications resulting from acne 12 (08.16)
Causes of refusal to prescribe isotretinoin A blood test indicates liver enzyme abnormality 115 (78.23)
Unreliable contraceptives 45 (03.61)
Central nervous system disorders 15 (10.20)
Current depression 7 (04.80)
Previous history of depression 7 (04.80)
Lipid profile abnormality 39 (26.53)
Pregnancy and fertility problems 72 (48.99)
The dose of isotretinoin is determined according to: The weight 66 (44.89)
General initial dose 102 (69.39)
Severity of acne 74 (50.34)
Sex 14 (09.52)
When do you ask the patient to perform pregnancy tests? Every month before the prescription 12 (08.16)
First session only 42 (28.57)
With periods of more than a month 15 (10.20)
Never, it is the patient's responsibility 78 (53.07)
What is the most effective method of contraception? Barrier contraceptives 17 (11.57)
Oral contraceptive drugs (OCP) 33 (22.45)
Intrauterine devices (IUD) 49 (33.35)
Long-term contraceptives such as progesterone injections 29 (19.73)
I will not prescribe anything 8 (05.44)
Depends on the patient 11 (07.48)
Do you refer patients with a prior history of depression to a specialist before starting isotretinoin? No 22 (14.97)
Yes 9 (06.12)
If there is a possibility of depression, I will not prescribe isotretinoin 96 (65.31)
Depends on the patient 20 (13.60)
When do you request blood tests after starting treatment? Per month 6 (04.08)
Once after 6-8 weeks 12 (08.16)
Every three months 43 (29.26)
Every two months 34 (23.13)
Periods exceeding three months 41 (27.89)
After a month and then every two months 5 (03.40)
None of the above 6 (04.08)
Repeated prescribing of isotretinoin course Less than a month 12 (08.16)
From one to three months 108 (73.46)
Three to six months 12 (08.16)
Six to nine months 7 (04.80)
Nine to twelve months 5 (03.40)
More than twelve months 3 (02.04)
Precautions for side effects Moisturizing eye drops 17 (11.57)
Not using contact lenses 6 (04.08)
Use sunscreen 77 (52.38)
Use moisturizing skin cream 31 (21.09)
Nasal moisturizer 6 (04.08)
Analgesic for joints and muscles 10 (06.8)