Evaluation of biophysical skin parameters and assessment of hair growth in patients with acne treated with isotretinoin

Abstract

IntroductionTreatment of the severe forms of acne vulgaris remains a challenge. Isotretinoin is a drug often used in these cases. Retinoids affect the mechanisms that play a role in the pathogenesis of acne, reduce the production of sebum and sizes of the sebaceous glands. However, isotretinoin appears to have undesirable side effects in the skin, mucous membranes and hair.AimThe aim of this study was to assess the effect of acne vulgaris treatment with isotretinoin on biophysical skin parameters: skin sebum and stratum corneum hydration levels, transepidermal water loss values, pH, erythema and hair growth parameters: total number, density and proportion of anagen hair.Material and methodsThe study included thirty patients with acne types: papulopustular, conglobata and phlegmonosa. Patients were treated with isotretinoin at a dose of 0.5–1.0 mg/kg/day for a period of 4–7 months. The measurements of skin biophysical parameters were performed before and after the treatment using Sebumeter SM815, Corneometer CM825, Tewameter TM300, MX Mexameter MX18 and Skin-pH-Meter PH908. Hair growth parameters were evaluated with FotoFinder Dermoscope using the TrichoScan Professional V3.0.8.76 software.ResultsThe results of biophysical skin parameter measurements after the treatment showed a reduction in the severity of seborrhea. However, the skin was dry, which confirmed a lowered degree of stratum corneum hydration and an increase in transepidermal water loss values. Moreover, severity of erythema, an increase in pH value, and variations in selected hair growth parameters: decrease in total count, density and proportion of anagen hair were demonstrated.ConclusionsThe reduction in the skin sebum levels was observed after the treatment. There was dryness of the skin, which was confirmed by biophysical skin parameter measurements. Changes in the hair growth parameters showed telogen effluvium hair loss.

The effect of systemic isotretinoin treatment on skin biophysicalparameters among patients with acne vulgaris*

“…Isotretinoin treatment reduces the size and secretions of the sebaceous glands (7,18,19). Sebumeter measurements revealed a significant decrease in the degree of cutaneous sebum content, as also confirmed by previous studies (7,18,19).…”

Dietary vitamin A regulates wingless-related MMTV integration site signaling to alter the hair cycle

“…4 In contrast, telogen effluvium occurs during oral treatment with at least either 25 mg/day of the synthetic retinoid Acitretin (Soriatane) and its parent compound Etretinate, 5, 6 or 0.5 mg/Kg body weight/day of isotretinoin. 7 Telogen effluvium occurs due to an arrest of the hair follicle in telogen and an anchorage defect that allows the hair to fall out. 5 Follicular hyperkeratosis develops during vitamin A deficiency in rats, 8, 9 juvenile cattle, 10 and humans.…”

Histological effect of high versus low dose isotretinoin and possible protective role of Tiron on skin of adult male albino rat

“…Stratum corneum appeared loose, disorganized and fragmented as isotretinoin has high lipophilic features; isotretinoin inclines to concentrate in the top of stratum corneum [29] . Kmieć et al [30] also reported a disturbance of the epidermal barrier, leading to interference of stratum corneum hydration.…”