Clinical pearl: comedone extraction for persistent macrocomedones while on isotretinoin therapy

Abstract

In the past, the safety of performing procedures while patients are on isotretinoin has been questioned. Macrocomedones are traditionally resistant to treatment with isotretinoin alone. The authors present a technique that is safe to employ while patients are on isotretinoin to effectively eliminate macrocomedones without complication.

Figure 1

After approximately 18 weeks of isotretinoin therapy alone, multiple macrocomedones are noted on the cheeks, chin, and glabella that are not responding to therapy.

Figure 2

Two months post completion of isotretinoin with multiple adjunctive in-office macrocomedone extractions of the glabella, cheeks, and chin with no residual scarring.