Inclusion Criteria:  Healthy persons of both sexes with moderate and severe acne. Age above 14 years.  Exclusion Criteria:  Pregnant and lactating women, immunocompromised patients. History of chronic liver disease, hyperlipidemia, non-inflammatory acne conditions, , history of neurologic disorders, history of neoplastic disorders, and history of cardiac disease. History of systemic acne treatment for at least 4 weeks prior to inclusion and no topical treatments for at least 2 weeks. Cases with known hypersensitivity reaction to isotretinoin.