Systemic isotretinoin for acne treatment: Ovarian reserve is safe with the low dose

Haroun, Asmaa M.; Ahmed, Mohammed Ahmed Ibrahim; Soliman, Ahmed S.; Abdel‐Ghaffar, Amira O.; Shams, Ghada M.

doi:10.1111/dth.15811

Cited by 3 publications

(2 citation statements)

References 27 publications

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“… 17 The dose is also an issue that cannot be ignored in pregnancy and teratogenicity, low-dose (0.25–0.4 mg/kg/day) ISO in treatment of moderate to severe acne seems to be safer on ovarian reserve. 100 …”

Section: Resultsmentioning

confidence: 99%

“…17 The dose is also an issue that cannot be ignored in pregnancy and teratogenicity, low-dose (0.25-0.4 mg/kg/day) ISO in treatment of moderate to severe acne seems to be safer on ovarian reserve. 100 In contrast, an international consensus on acne published by the Global Alliance for Improved Outcomes did not make a specific recommendation for ISO dosage, but it only recommended continuing to use ISO for a month after the acne cleared up, regardless of the cumulative dose. 101,102 Rademaker 103 took the attitude that neither daily nor cumulative dosages influenced relapse of AV so long as treatment was continued for ≥2 months after the acne had completely resolved.…”

Section: Dose Related Effectsmentioning

confidence: 99%

See 1 more Smart Citation

Physiological and Psychological Effects of Isotretinoin in the Treatment of Patients with Acne: A Narrative Review

Ding¹,

Zheng²,

Jin³

2023

CCID

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Isotretinoin (ISO) is a powerful vitamin A derivative that offers the potential for treatment of permanent remission of acne; however, its potential side effects on both physiological and psychological aspects limit its application. This article reviews the side effects of ISO from physiological and psychological aspects in detail, to better screen the suitable population of ISO and improve the efficiency of clinical treatment. Our findings indicate that ISO may cause teratogenicity, skin reactions, ocular reactions, changes in blood indicators, and occasional acne fulminans. To optimize clinical treatment, more attention should be paid to identifying the specific conditions under which these reactions occur, how severe they are, and how they subside to alleviate patient concerns. Regarding the controversial issue of psychological side effects caused by ISO, researchers should shift their focus to the psychological problems that acne itself may cause.

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Section: Resultsmentioning

confidence: 99%

Section: Dose Related Effectsmentioning

confidence: 99%

Physiological and Psychological Effects of Isotretinoin in the Treatment of Patients with Acne: A Narrative Review

Ding¹,

Zheng²,

Jin³

2023

CCID

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Exploring the association between isotretinoin and sexual dysfunction: a comprehensive scoping review

Tan,

Kennedy,

Rademaker

2024

Clinical and Experimental Dermatology

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Background The potential link between isotretinoin and sexual dysfunction has been reported in various studies. However, such an association has not been explored within the context of a literature review until now. Objectives To evaluate the methodology and quality of studies investigating this association, and to examine the definitions of sexual dysfunction used. Methods A scoping review approach was used to identify peer-reviewed research articles. The search terms used were: “isotretinoin”, “sexual dysfunction”, “erectile dysfunction”, “ejaculatory disorders” “decreased libido”, “female sexual interest”, “female arousal disorder”, “libido”, “pelvic pain”, “dyspareunia”, “orgasmic disorder”, “impotence”, “ovaries”, “fertility” and “menstrual irregularity”. Results 54 peer-reviewed manuscripts consisting of 8 animal studies and 46 human studies consisting of 2,420 patients were included. Of the studies in humans, there were 18 case reports/case series, 2 case-controls, 4 cross-sectional studies, 6 longitudinal studies, 3 pharmacovigilance reports and 13 cohort studies. The most frequently observed dose range of isotretinoin was 0.5-1.0mg/kg/day usually for a duration of 1-6 months. More than half of the studies (54%, n=25) reported a beneficial or neutral effect of isotretinoin on sexual function. The majority of studies (89%, n = 41) were categorized as Oxford evidenced-based-medicine level 4. Conclusions This scoping review revealed very weak evidence supporting a link between isotretinoin and sexual dysfunction. Notably, the diverse definitions of sexual dysfunction pose a significant challenge for comparative analysis. The authors advocate for a standardized definition of sexual dysfunction and a framework for determining causality in order to contribute to a more comprehensive understanding of the relationship between isotretinoin and sexual dysfunction.

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The impact of oral isotretinoin on ovarian functions of acne patients complaining of polycystic ovarian syndrome: a prospective study

Elnagar,

Hashem,

Aboelwafa

et al. 2024

J Ovarian Res

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Background Women have polycystic ovarian syndrome (PCOS) at higher rates than any other endocrine condition with an average incidence rate of 6 to 8%. Acne is an immune mediate common condition frequently affecting adolescents and adults and is often associated with PCOS. The objective of the study was to assess the impact of oral isotretinoin on ovarian functions of acne patients suffering from PCOS. Forty women with a clinical diagnosis of acne as well as PCOS participated in this prospective clinical trial. Participants were given oral doses of isotretinoin ranging from 0.5 to 1 milligram per kilogram (mg/kg), for a total of 120 to 150 mg/kg. To establish baseline values of hormone levels, on days 2–5 of the menstrual cycle, venous blood samples were obtained. Moreover, global acne grading system (GAGS), follicle count, and bilateral ovarian volumes were evaluated both before and after isotretinoin treatment. Results A significant reduction in global acne score from pre-treatment levels to post-treatment levels was observed (11.58 ± 5.857 vs. 1.65 ± 1.369). Ovarian volume was significantly reduced from 10.26 ± 1.539 before treatment to 8.74 ± 1.436 after treatment on the right side (P < 0.001) and from 11.08 ± 1.564 before treatment to 9.36 ± 1.479 after treatment on the left side (P < 0.001). A significant reduction in free testosterone level and hirsutism scores were observed after treatment (P < 0.001; P < 0.01 respectively. Conclusion Isotretinoin may exert beneficial effects in hyperandrogenic women with PCOS and needs to be further evaluated by large multicentre controlled trials.

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Systemic isotretinoin for acne treatment: Ovarian reserve is safe with the low dose

Cited by 3 publications

References 27 publications

Physiological and Psychological Effects of Isotretinoin in the Treatment of Patients with Acne: A Narrative Review

Physiological and Psychological Effects of Isotretinoin in the Treatment of Patients with Acne: A Narrative Review

Exploring the association between isotretinoin and sexual dysfunction: a comprehensive scoping review

The impact of oral isotretinoin on ovarian functions of acne patients complaining of polycystic ovarian syndrome: a prospective study

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