A 20-year-old male suffered severe from of acne vulgaris for > 4 years. He presented with many inflammatory papules, nodules, cysts and scars involved the cheeks, chin and forehead.  A 3-month-course of Isotretinoin (Retane) 40 mg capsule once daily resulted in fantastic improvement in spite of moderate-severe xerotic mucocutaneous side effects affected mainly the lips and to a lesser extent the forearms.