Usually, our doctor will start us on a lower dose for the first month or two so that we can acclimate to the side effects (at least to some extent), and then increase the dose for the rest of the 16 to 20 weeks severe acne treatment course. However, depending on the acne treatment results achieved and in some cases, higher doses for longer than 20 weeks may be required. Also, in some very severe cases of acne, oral prednisone (i.e. a corticosteroid commonly used to treat inflammation), will be given for a duration of 2 to 6 weeks, usually before oral isotretinoin acne treatment is begun.
We may want to know that before we start oral isotretinoin, we should have a detailed discussion with our doctor regarding any concerns that we may have about oral isotretinoin acne treatment, more so if we have any personal or family history of depression. The doctor will give us a booklet that the makers of oral isotretinoin provide; this is for us to review at home and to discuss with our family. Once we have made up our mind, we and our doctor must sign and date on several pages on our next visit. At this pre-oral isotretinoin visit, we are required to have our baseline blood tests, which will be repeated monthly while we are taking the drug.
If we are a woman, the doctor will also review pregnancy and contraceptive issues with us and make sure that we are not pregnant at the start of oral isotretinoin treatment. We have to aware that the risk of birth defects exists while the retinoid is in our body. Once the retinoid is cleared, usually 6 weeks after discontinuing oral isotretinoin acne therapy, there is no longer a risk. Also, patient information form and video are obtainable from the manufacturer to help us better understand on any contraceptive and pregnancy issues.