Oral isotretinoin for acne: a complete overview

Villani, Alessia; Nastro, Francesca Fiori; Vico, Francesca di; Fabbrocini, Gabriella; Annunziata, Maria Carmela; Genco, Lucia

doi:10.1080/14740338.2022.2102605

Cited by 18 publications

(15 citation statements)

References 98 publications

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“…10,21 However, treatment outcomes have varied widely from one study to another even when using the same therapy regimen. 16,22,23 Therefore, recent studies have concluded that individual conditions should be considered when designing treatment protocols for moderate acne. 16,24 However, the current prescription still fails to take into account different gradations of the severity of moderate acne.…”

Section: Results For Side-effects and Patient Satisfactionmentioning

confidence: 99%

“…Several therapy regimens based on conventional, low and intermittent doses have been demonstrated to achieve good clinical efficacy in the treatment of moderate acne 10,21 . However, treatment outcomes have varied widely from one study to another even when using the same therapy regimen 16,22,23 . Therefore, recent studies have concluded that individual conditions should be considered when designing treatment protocols for moderate acne 16,24 .…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the efficacy and relapse rates of treatment protocols for moderate acne using isotretinoin based on the global acne grading system: Randomized, controlled, comparative study

Kassem

Ismail

Hassan

2022

Dermatologic Therapy

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Protocols for treating acne with isotretinoin have varied widely because some factors associated with relapse and treatment duration have not yet been fully determined. This paper evaluates the effectiveness of conventional, low, and intermittent isotretinoin dosage protocols in the treatment of moderate acne and investigates the relationships between GAGS score, treatment duration and relapse rate. The 107 patients with moderate acne were randomly divided into three groups who received isotretinoin for 24 weeks (Group A: 0.5–1 mg/kg/day; Group B: 0.25–0.4 mg/kg/day; Group C: 0.5–0.7 mg/kg/day for 1 week out of every 4 weeks). The results show that both conventional and continuous low doses achieved full clinical effectiveness with minimum relapse rates. However, fewer side effects and better patient satisfaction were reported with the low dose. Significant differences in GAGS scores after 24 weeks were found between groups B and C (p = 0.037) and between groups A and C (p < 0.001), while no significant differences were found between groups A and B (p = 0.153). It was observed that relapse rate increased with initial GAGS score. The average relapse rate was 58.0% for those with initial GAGS scores of 25–30 compared with 5.5% for those with scores of 19–24. It was also noticed that, among the patients who relapsed, the highest percentage (56.3%) were in the age group <20 years. However, GAGS (β = 0.646, t = 8.323, p < 0.001) was found to be a better predictor of relapse than age (β = 0.083, t = 1.073, p = 0.286). These results suggest that initial GAGS score is an important factor in determining the treatment protocol for moderate acne. Furthermore, this study recommends that a low‐dose treatment is most suitable when GAGS <25, as it can achieve complete clearance of acne with minimal relapses and side effects.

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Section: Results For Side-effects and Patient Satisfactionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evaluation of the efficacy and relapse rates of treatment protocols for moderate acne using isotretinoin based on the global acne grading system: Randomized, controlled, comparative study

Kassem

Ismail

Hassan

2022

Dermatologic Therapy

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“…Acne treatments take several forms due to its complex etiology, though primary interventions for both sexes include combinations of topical retinoids, benzoyl peroxides, and antibiotics 10 . In more severe cases, isotretinoin (e.g., Accutane) may be prescribed 82 . For adolescent girls and women, combined HC are also effective in treating low to moderate acne 83 .…”

Section: Acne Prevalence and Coursementioning

confidence: 99%

“…10 In more severe cases, isotretinoin (e.g., Accutane) may be prescribed. 82 For adolescent girls and women, combined HC are also effective in treating low to moderate acne. 83 Nonetheless, acne is a common 12 and often prolonged skin condition 13 characterized by high variability in its etiology, 10 presentation, and disease course, 10 making it a nuanced physical condition that unfolds dynamically over time and is associated with subclinical features 84 and clinical diagnoses of taxing disorders like depression and anxiety.…”

Section: Acne Prevalence and Coursementioning

confidence: 99%

Acne and its association with internalizing problems

Hammill

Vaillancourt

2023

Dermatological Reviews

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Acne vulgaris or “acne” is a prevalent and burdensome cutaneous condition that has been linked with unique mental health implications. Clinical (i.e., general and social anxiety, and major depression) and subclinical indicators (e.g., excessive worry, social self‐consciousness, and low self‐esteem) of internalizing disorders have been associated with acne across demographics (e.g., age groups and cultures). Considering the persistent burden of disease associated with these mental health outcomes, our primary aim was to concretely synthesize the relation between acne and internalizing symptoms. A secondary aim was to address the role that combined oral contraceptives and isotretinoin (e.g., Accutane), widely prescribed medical treatments for acne, may play in this relation as both have been linked to depression and anxiety. We discuss practical implications that may strengthen the effective biopsychosocial management of acne for suffering individuals. This review actively upholds and amplifies the call for longitudinal research that integrates the developmental psychology and dermatology literature to effectively treat acne in its entirety, including mental health.

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“…6,[8][9][10][11] Oral isotretinoin is one of the most effective therapies in the treatment of moderate-to-severe acne. 12,13 In comparison to the standard dose of isotretinoin, low-dose isotretinoin (0.1-0.3 mg/kg daily) is more recommended due to their lower side effects. 14 It was reported that oral isotretinoin can increase the generation of collagen fibers.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of low‐dose oral isotretinoin monotherapy versus combined therapy with picosecond laser for the treatment of acne scars in Asian population

Xue

Huang

et al. 2023

Lasers Surg Med

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Purpose Acne scars are common in patients with moderate to severe acne. Isotretinoin is the first‐line treatment for those patients, but whether oral isotretinoin can improve acne scar is not clear. Picosecond lasers (FxPico) has been reported to improve acne scars. In the present study, we evaluated the clinical efficacy of low‐dose isotretinoin with or without FxPico treatment for acne scars. Materials and Methods A total of 48 patients with acne scars were enrolled and were randomly assigned to receive low dose oral isotretinoin or not. For all the patients in both treatment groups, one side of face were randomly assigned to be treated with picosecond laser. Assessments, including photos, échelle d'évaluation clinique des cicatrices d'acné (ECCA) and Global Acne Grading System (GAGS) score, the number of lesions, melanin and erythema indexes, transepidermal water loss were assessed at 0, 1, 2, and 3 month. Side effects, Dermatology Life Quality Index (DLQI) and satisfaction were recorded before and after the study. Results A total of 44 patients completed the study (24 received oral low dose isotretinoin and 20 did not). Low dose oral isotretinoin treated group showed significant improvement on ECCA (from 112.5 [50–180] to 105 [50–160]), GAGS score (from 12.6 ± 3.3 to 10.1 ± 3.0), the count of papules (from 4.3 ± 3.7 to 1.0 ± 1.5) than the blank group, and higher improvement were noticed after isotretinoin combined with FxPico. All the side effects were temporary and tolerable, no adverse effects were observed. Higher DLQI and patients' satisfaction were achieved by oral isotretinoin alone and isotretinoin combined with FxPico. Conclusions This is the first paper showing the improvement of scars by early low dose‐isotretinoin intervention with or without the combination of picosecond laser. Early intervention with oral low‐dose isotretinoin is effective for the treatment and prevention of acne scars, the combined therapy with FxPico can achieve better outcome.

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Oral isotretinoin for acne: a complete overview

Cited by 18 publications

References 98 publications

Evaluation of the efficacy and relapse rates of treatment protocols for moderate acne using isotretinoin based on the global acne grading system: Randomized, controlled, comparative study

Evaluation of the efficacy and relapse rates of treatment protocols for moderate acne using isotretinoin based on the global acne grading system: Randomized, controlled, comparative study

Acne and its association with internalizing problems

Efficacy and safety of low‐dose oral isotretinoin monotherapy versus combined therapy with picosecond laser for the treatment of acne scars in Asian population

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