A review of systemic retinoid therapy for acne and related conditions.

Oral isotretinoin, since its introduction more than 20 years ago, has been and still is the "gold standard" in the treatment of acne and its variants. This is the only approach to acne with the possibility of a permanent "cure" or long term remission. The role of isotretinoin has evolved with higher dosage schedules and use earlier in the course of the disease. The frequency of laboratory monitoring has diminished along with associated costs based on 2 decades of experience. Pregnancy-associated safeguards have become a more prominent facet of oral retinoid therapy leading to increased safety for its use in females of child-bearing potential.