I am aware that low-dose isotretinoin (Accutane) at a range of 5mg-20mg daily is effective in treating rosacea. However, I have heard but never seen any study suggesting that high-dose Accutane can actually cause rosacea. Is this true? If so, what dosage would be considered high-dose, such as 2mg/kg or more daily? I am referring to high-dose as a potential cause of rosacea.
Throughout my 20 years of prescribing Accutane as a dermatologist, I have never found the need to exceed a dosage of 2 mg/kg. Therefore, I would advise caution when considering doses in that range. To date, I have not witnessed Accutane causing Rosacea.
The exact cause of rosacea is unknown. However, certain factors can worsen the condition, such as anything that irritates or warms up the face. The primary issue in rosacea is the instability of facial blood vessels, which easily dilate and close slowly. While the dryness caused by Accutane treatment can potentially irritate rosacea-prone skin, you can help manage it by avoiding other irritants, using an oil-free, fragrance-free, non-comedogenic moisturizer, and preferably one with broad-spectrum sunscreen. It is important to note that dryness, skin sensitivity, and irritation can increase with higher doses of Accutane like the one you mentioned.
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