A randomised study to evaluate the efficacy of isotretinoin, electrodessication and comedone extraction in the treatment of comedonal acne
Keywords:Comedonal acne, Isotretinoin, Electrodessication
Background: Comedonal acne commonly seen in adolescents and young patients which is refractory to standard treatments. This study is being undertaken to determine the efficacy and adverse effects of oral isotretinoin, electrodessication and comedone extraction in patients of comedonalacne.
Methods: A total of 120 patients of comedonal acne were enrolled and randomly divided into 4 groups of 30 patients each. Group A, B, C and D patients were treated with isotretinoin (20 mg daily), electrodessication, comedone extraction (4 weeks interval) and topical antibiotic daily for 12 weeks. The response in each group was assessed based on decrease in total comedonal count after 12 weeks of treatment. Statistical analysis was done using chi square test.
Results: Eighty seven (72%) cases had predominantly closed comedones and 33 (27%) cases showed open comedones. After 12 weeks of treatment, more than 75% decrease in comedonal count was seen in 60% of patients in electrodessication group followed by 30% (isotretinoin), 13.3% (comedone extraction). The decrease in total number of comedone was significantly higher with electrodessication (84.4%) followed by isotretinoin (73%), comedone extraction (43.2%) and topical antibiotic (5.7%). After follow up of 3 months, recurrence of comedones was least with isotretinoin followed by comedone extraction and electrodessication.
Conclusions: For comedonal acne, initial electrodessication followed by isotretinoin over 12 weeks gives the best outcome of quick remission and least recurrence. Electrodessication and comedone extraction are the preferred modalities in patients with predominantly closed and open comedones respectively.
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