Effect of oral 13-cis-retinoic acid at three dose levels on sustainable rates of sebum secretion and on acne.

Changes in sustainable rates of sebum secretion were followed in twenty patients with severe acne who were receiving oral treatment with 13-cis-retinoic acid in dosages of 0.1, 0.5, or 1.0 mg/kg/day. Sebum secretion was measured by absorption of skin surface lipid into bentonite clay and estimation of the amount of absorbed sebum by measurement of its wax ester component. Pretreatment rates of sebum secretion in the patients were greatly elevated in comparison with previously measured values in young adult subjects without acne. After 4 weeks of treatment, mean rates of sebum secretion on all three dose levels fell to or below the range for normal subjects. On-treatment rates of sebum secretion were significantly lower in patients on the highest dose compared to patients on the lowest dose. When the drug was discontinued, rates of sebum secretion recovered slowly. Clinical response was excellent in most of the subjects. The five subjects with least favorable response clinically all had better than average suppression of sebum production.