How do you manage acne relapses after isotretinoin?

This is a good question, and the answer depends on several factors, the most notable of which is the severity of the relapse. Oftentimes, the relapse is not as severe as the original outbreak for which the original isotretinoin course of therapy was prescribed. When this is the case, I start with conventional therapy (antibiotic, topical retinoid + benzoyl peroxide, and spironolactone in women), as it will often bring a relatively minor flare under control. If the relapse is severe enough, I wil...