The results of therapy and further follow-up of patients with moderate to severe acne using isotretinoin (Aknekutan) are reported. All the patients were previously treated and received the conventional form of isotretinoin, but recurrence of the disease occurred within a year. This study has shown that the correct approach and adequate cumulative dose of Aknekutan per course (110-120 mg/kg) makes it possible to achieve pronounced and persistent clinical outcome. Aknekutan have shown high efficacy and anti-relapse activity in treatment of moderate to severe acne, even in cases of relapse after prior therapy using conventional form of isotretinoin. Nevertheless, according to the results of the analysis, the authors recommend against using low-dose regimens of the drug in young patients with back and chest skin pathology. The authors emphasize the possibility of using properly adjusted daily dose of the drug to achieve its total cumulative dose in patients with somatic pathology, severe acne and acne inverse. The therapy can be continued in summertime provided that moisturizers and sunscreens are used.