Retinization Schedule: Your Simple Guide to Isotretinoin Dosing

If you’re starting isotretinoin for acne, the biggest question is usually "how fast should I go up?" That’s what a retinization schedule is for – it tells you how to raise the dose slowly so your skin adjusts and side effects stay low.

Why a Retinization Schedule Matters

Isotretinoin is powerful. Jumping straight to a high dose can give you dry lips, cracked skin, or even a sore nose. A step‑by‑step plan spreads the load over weeks, giving your body time to get used to the drug. Most doctors start at 0.25 mg/kg/day and add a little each week until they hit the target, usually between 0.5 and 1 mg/kg/day. The exact numbers depend on your weight, how severe your acne is, and how well you tolerate the medicine.

Step‑by‑Step Dosing Plan

Week 1–2: Low start – Take the calculated low dose (often a quarter of a 20 mg tablet). You’ll notice a few dry patches, but that’s normal. Keep a water bottle handy and use a good lip balm.

Week 3–4: First bump – Increase by another 0.25 mg/kg/day. If you’re on a 70 kg person, that’s about 5 mg extra. Most people split the tablet to hit the right amount. Continue moisturizing and watch for any new side effects.

Week 5–6: Mid‑point – You should be around 0.5 mg/kg/day now. This is often the sweet spot for many patients. Your acne should start to clear noticeably. If you’re still feeling okay, keep the dose steady for another two weeks.

Week 7 and beyond: Final increase – Some dermatologists push to 0.75–1 mg/kg/day if your acne is stubborn. Increase slowly, no more than 0.25 mg/kg/day per two‑week block. Stop the climb if you get severe dryness, joint pain, or headaches.

Throughout the whole course, get blood tests every month. Your liver enzymes and lipids need a check‑up. If any numbers are high, your doctor may lower the dose or pause treatment.

When you reach the target dose, stay on it for about 4–6 months. That’s the usual length to finish the course. After stopping, some doctors suggest a short taper – a few weeks at a slightly lower dose – to give your skin a gentle transition.

Remember, every person is different. Use the schedule as a guide, not a rulebook. Talk to your dermatologist if you feel any discomfort or if your acne isn’t improving after a month at the target dose.

Bottom line: start low, go slow, and keep an eye on your body. A well‑planned retinization schedule helps you get clear skin without the scary side effects that can happen when you rush the process.