This 20-member modified Delphi consensus (ERAISE ACNE algorithm), developed in the context of Indian clinical practice, with relevance to regions having similar patient settings, outlined first-line isotretinoin indications for severe conglobate, nodulocystic, and severe papulopustular acne in adults and adolescents and risk-based use in select moderate cases.

Early initiation of isotretinoin after failure of first-line therapy was endorsed to curb acne progression, scarring, and postinflammatory hyperpigmentation, with acknowledged benefits in quality of life.

Conventional daily dosing (0.5–1 mg/kg/day) was preferred for severe acne, while low-dose regimens were acceptable for moderate or persistent mild acne.

Risk-adapted laboratory monitoring rather than a universal approach was emphasized, with recognition of common and less frequent adverse effects, precautions, and contraindications.

There was consensus on use of procedures such as comedone extraction, chemical peels, and fractional lasers during isotretinoin therapy in appropriate candidates and on isotretinoin use for select nonacne indications.