The use of isotretinoin in acne therapy in early childhood and its effect on the occurrence of acne symptoms later in life. Eight-year follow-up

Abstract

Introduction: Acne vulgaris is a chronic inflammatory skin disease of the pilosebaceous follicles that affects patients of all ages. Aim: Use of isotretinoin in the early stages of the disease to prevent subsequent lesions of acne, including prolonged treatment and acne scars at a later age. Material and methods: A retrospective, comparative study was carried between January 2010 and November 2018. The study population consisted of 90 children aged 9-18 years with acne. During treatment by isotretinoin the clinical evaluation was done every month. Patients were divided into three groups according to age. One of the qualification criteria was follow-up visits. Results: A total of 90 children (67.8% females; mean age: 13.5 years) were enrolled. In group A (30 individuals -aged 9-11) and B (30 individuals -aged 12-13), treatment was terminated 2 months after clinical improvement (mean: 3 months). In control group C (30 individuals -aged 14-18), treatment was carried out using average cumulative dose 135 mg/kg bw/day. All groups showed up for follow-up. after 1 to 8 years. In groups A and B, 13 people underwent a second acne treatment; in 3.33% oral isotretinoin was used, in 18.33% topical treatment. In group C, 30 (100%) individuals underwent a second acne treatment; in 20% oral isotretinoin was used, and 80% required a topical treatment. Acne scars and post acne hyperpigmentation have been documented in 73.33% in group C. Conclusions: Early, reasonable and short-term use of isotretinoin can reduce the incidence of acne in the future and reduce the occurrence of secondary acne symptoms.

Isotretinoin-Related Eye Dryness in Acne Patients in Qassim, Saudi Arabia

“…However, among those who did stop using isotretinoin, 15.9% ceased usage less than two months ago, while 10.3% stopped more than two months ago. These findings align with the study, which reported similar proportions of participants who discontinued isotretinoin usage within different timeframes [ 13 , 14 ].…”

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

“… 13 , 14 , 30 It might be because that treatment with ISO could result in a decrease in skin hydration. 42 In the study proved by Brzezinski et al, 15 concluding 90 teenagers with acne treated with ISO, the incidence of dry lips was 100%. Chapped lips were also the adverse reaction.…”

“… 13 Vallerand et al 14 collected data from 11 trials meeting eligibility for review (total 760 patients randomized) and found that the rate of adverse events was twice as high in the ISO group compared to the control group across all trials. In a 2022 study by Brzezinski et al 15 of 90 adolescent participants treated with ISO for acne, 11 different adverse effects were noted during ISO treatment. Next, we begin to tease out the physical side effects of ISO treatment with the three prominent adverse effects mentioned above.…”

Cross-Sectional Assessment of Dermatologists’ Knowledge and Attitude Towards Isotretinoin-Related Ocular Side Effects in Aseer, Saudi Arabia

“…The study divided patients into three groups (A, B, C) based on age that were followed up for one to eight years. The results showed that 73.33% of children in Group C experienced acne scars and post-acne hyperpigmentation [ 22 ]. Elshafie et al [ 21 ] reported that among 103 Egyptian dermatologists, 92.8% of them sometimes prescribed isotretinoin alone for moderate to severe nodulo-cystic acne, 4.5% rarely prescribed it (only for a case with primary comedone), and 2.7% always prescribed the drug for all acne types.…”