Case Report: Adult Female Acne Managed With Isotretinoin (Accutane) in Katy & Houston, Texas
At Village Dermatology, we provide comprehensive care for patients with persistent and treatment-resistant acne. Isotretinoin (Accutane) remains one of the most effective options for moderate to severe acne, particularly when other therapies have failed.
Patient Background
A 41-year-old female returned for a follow-up visit for facial acne. She was initially evaluated on November 21, 2025, at which time she began isotretinoin 40 mg twice daily (80 mg total daily dose), taken with a fatty meal. She presented today for focused monitoring while continuing therapy.
Clinical Examination
A focused facial examination was performed with dermoscopy. Findings included:
Comedonal papules
Inflammatory papules and pustules
Two new acne breakouts involving the nose and cheek
Despite reaching her cumulative dose goal, the patient continued to experience mild active lesions.
The patient appeared well-developed, well-nourished, alert, and in no acute distress.
Treatment Course & Management Plan
The patient reported no significant side effects from isotretinoin therapy. Given the presence of new breakouts, the decision was made to continue isotretinoin at 80 mg daily to further improve disease control.
Key Treatment Details:
Medication: Isotretinoin 40 mg capsules
Dose: 40 mg twice daily
Month of Therapy: Month 5
Protocol: 1 mg/kg until cumulative dose of 200–220 mg/kg
A urine pregnancy test was performed in clinic and confirmed to be negative. The patient was successfully confirmed in iPledge, and her prescription was sent.
Isotretinoin Counseling & Monitoring
Extensive counseling was provided, including:
Use of two forms of contraception (secondary method: male vasectomy)
Monthly pregnancy testing and lab monitoring
Avoiding blood donation
Avoiding elective surgery for six months after treatment completion
Not sharing medication
Monitoring for side effects such as headaches, fatigue, abdominal pain, rash, or vision changes
The patient verbalized understanding of all risks and benefits.
Skin Care Recommendations
To support treatment success, the patient was advised to use:
Non-comedogenic cleansers
Gentle moisturizers
Broad-spectrum sunscreen SPF 30+
She was counseled that improvement continues over time, with 60–80% improvement typically seen by 2–3 months, and further clearing expected as therapy continues.
Follow-Up
The patient will return in one month for continued isotretinoin monitoring and acne management.
Expert Acne & Accutane Treatment in Katy & Houston, Texas
At Village Dermatology, we specialize in adult acne treatment, including safe and closely monitored isotretinoin therapy. Our dermatologists provide personalized care to help patients achieve long-term acne control and prevent scarring.
📍 Serving Katy and Houston, Texas
