Majority of cases of cystic acne can be successfully treated with one 4-6 month course of
isotretinoin (
Accutane) at a dosage of 0.5-2.0 mg/kg body weight per day (approximately 40-160 mg per day in your case). Continued recovery and prolonged remission after discontinuation of therapy is expected, so it is not required to maintain treatment until total clearance is achieved. Progress you made should not be lost. However, in some, most severe cases, second course of therapy may be needed.