Comparative Study of Efficacy of Low-Dose Continuous and Low-Dose Intermittent Oral Isotretinoin Therapy in Moderate Acne Vulgaris

Background: Acne vulgaris is a common dermatological condition that significantly affects quality of life. Isotretinoin is the most effective treatment for moderate-to-severe cases. Still, concerns regarding dosing strategies and adverse effects have led to investigations into alternative regimens such as low-dose continuous and intermittent therapies. Objective: To compare the efficacy of low-dose continuous and low-dose intermittent oral isotretinoin therapy in patients with moderate acne vulgaris. Study Design: Quasi-experimental design. Setting: Department of Dermatology, Combined Military Hospital, Nowshera, Pakistan. Duration of Study: 08-February-2025 to 08-June-2025. Methods: A total of 112 participants aged 18–60 years with clinically diagnosed moderate acne vulgaris were enrolled and equally allocated into two groups (n=56 each). Group A received continuous oral isotretinoin (20 mg once daily for 2 months), while Group B received intermittent oral isotretinoin (20 mg once daily for 1 week per 4-week cycle over 2 months). Efficacy was defined as at least a 10-point reduction in Global Acne Grading System (GAGS) score from baseline to 2 months. An independent t-test was applied to compare pre- and post-treatment GAGS scores, with a significance threshold set at p ≤ 0.05. Results: The mean age of participants was 30.71 ± 10.13 years in Group A and 29.43 ± 8.55 years in Group B. Following treatment, mean GAGS scores were 10.43 ± 5.53 in Group A and 8.75 ± 5.99 in Group B. No statistically significant difference was observed between the groups (p = 0.12). Both regimens demonstrated clinically meaningful improvement. Conclusion: Low-dose continuous and low-dose intermittent oral isotretinoin therapies are similarly effective for the management of moderate acne vulgaris. Both regimens can be considered safe and effective alternatives in clinical practice.