Do you transition to a topical retinoid after a patient completes a course of isotretinoin?   

Yes. I give them the RX and tell them to start 4-6 weeks after completing the isotret course. Most of my acne patients are adult females (my niche), so using the retinoid is integral for anti-aging. I also find it helpful with any leftover scarring or pigmentation. Choice of retinoids depends on ski...

I also start my patients on a retinoid cream 4-6 weeks after isotretinoin It helps with the residual discoloration and scarring and prevents further acne flare-ups. Also, in women, it is an excellent anti-aging medication that they can use for the rest of their lives.

I never give a topical retinoid upon completion of my courses of isotretinoin. I am a pediatric dermatologist and utilize the high-dose isotretinoin approach. Not many of my patients with a total cumulative dose of greater than 220 mg/kg isotretinoin and then clear for 1 month on med need maintenanc...

I start them on Tretinoin 0.025 or Tretinoin 0.05% cream hs 2-4 weeks after stopping isotretinoin.  

I always do; I emphasize that years ago when we used isotretinoin, we did not do this and I recall seeing more recurrent severe acne. I tell patients this step protects their investment in clear skin. I was taught years ago that keratinocytes have a 'memory' for retinoids so a topical after isotret...

It depends on the patient's overall course and response. For those that took longer to clear, I strongly recommend and prescribe a topical retinoid, usually adapalene. For those who clear quickly, I make it more optional. I have found OTC and/or Rx adapalene to be tolerated best.