An otherwise healthy 18-year-old girl is brought to the physician because she is very upset about the acne scarring, which involves her face, chest, and back. It has not improved with her current combination therapy of oral antibiotic and topical benzoyl peroxide. She is sexually active with one male partner, and they use condoms consistently. Physical examination shows nodulocystic acne with scarring on the face, chin, and upper back. The patient is interested in isotretinoin treatment. Which of the following is the best next step in management of this patient?

Question

An otherwise healthy 18-year-old girl is brought to the physician because she is very upset about the acne scarring, which involves her face, chest, and back. It has not improved with her current combination therapy of oral antibiotic and topical benzoyl peroxide. She is sexually active with one male partner, and they use condoms consistently. Physical examination shows nodulocystic acne with scarring on the face, chin, and upper back.  The patient is interested in isotretinoin treatment.  Which of the following is the best next step in management of this patient?

Quizplus · Accepted Answer

Eductional Objective: Contraception should start one month before isotretinoin therapy and be continued until one month after isotretinoin therapy is completed. The pregnancy test should be repeated monthly up to one month after ceasing systemic retinoid therapy. Meanwhile, the patient should commit to a "double" contraception strategy, a combination of an oral as well as another contraceptive (e.g., barrier contraception, IUD).

An Otherwise Healthy 18-Year-Old Girl Is Brought to the Physician