The use of isotretinoin in acne therapy in early childhood and its effect on the occurrence of acne symptoms later in life. Eight-year follow-up

Introduction
Acne vulgaris is a chronic inflammatory skin disease of the pilosebaceous follicles that affects patients of all ages.

Aim
Use of isotretinoin in the early stages of the disease to prevent subsequent lesions of acne, including prolonged treatment and acne scars at a later age.

Material and methods
A retrospective, comparative study was carried between January 2010 and November 2018. The study population consisted of 90 children aged 9–18 years with acne. During treatment by isotretinoin the clinical evaluation was done every month. Patients were divided into three groups according to age. One of the qualification criteria was follow-up visits.

Results
A total of 90 children (67.8% females; mean age: 13.5 years) were enrolled. In group A (30 individuals – aged 9–11) and B (30 individuals – aged 12–13), treatment was terminated 2 months after clinical improvement (mean: 3 months). In control group C (30 individuals – aged 14–18), treatment was carried out using average cumulative dose 135 mg/kg bw/day. All groups showed up for follow-up. after 1 to 8 years. In groups A and B, 13 people underwent a second acne treatment; in 3.33% oral isotretinoin was used, in 18.33% topical treatment. In group C, 30 (100%) individuals underwent a second acne treatment; in 20% oral isotretinoin was used, and 80% required a topical treatment. Acne scars and post acne hyperpigmentation have been documented in 73.33% in group C.

Conclusions
Early, reasonable and short-term use of isotretinoin can reduce the incidence of acne in the future and reduce the occurrence of secondary acne symptoms.