Skip to main content Skip to main navigation menu Skip to site footer
  • Register
  • Login
  • Menu
  • Home
  • Current
  • Archives
  • Announcements
  • About
    • About the Journal
    • Submissions
    • Editorial Team
    • Privacy Statement
    • Contact
  • Register
  • Login

Quality in Sport

Outcomes and Adverse Effects of Isotretinoin in Acne Treatment: A Systematic Review
  • Home
  • /
  • Outcomes and Adverse Effects of Isotretinoin in Acne Treatment: A Systematic Review
  1. Home /
  2. Archives /
  3. Vol. 33 (2024) /
  4. Medical Sciences

Outcomes and Adverse Effects of Isotretinoin in Acne Treatment: A Systematic Review

Authors

  • Kinga Tylczyńska Cardinal Stefan Wyszynski University in Warsaw, Kazimierza Wóycickiego 1/3, 01-938 Warsaw, Poland https://orcid.org/0009-0008-1820-3013
  • Natalia Tylczyńska Cardinal Stefan Wyszynski University in Warsaw, Kazimierza Wóycickiego 1/3, 01-938 Warsaw, Poland https://orcid.org/0009-0002-8668-0272
  • Jakub Skiba Independent Public Health Care Facility in Koło, Księcia Józefa Poniatowskiego 25, 62-600 Koło, Poland https://orcid.org/0009-0002-2451-6477
  • Zuzanna Skiba Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland https://orcid.org/0009-0001-7583-5868
  • Kinga Kowalik Wolski Hospital, Marcina Kasprzaka 17, 01-211 Warsaw, Poland https://orcid.org/0009-0000-4894-6987
  • Maria Michalska Wolski Hospital, Marcina Kasprzaka 17, 01-211 Warsaw, Poland https://orcid.org/0009-0004-7822-8299
  • Aleksandra Zielińska Praski Hospital in Warsaw, al. „Solidarności” 67, 03-401 Warsaw, Poland https://orcid.org/0009-0007-4791-9160
  • Szymon Szypulski Infant Jesus Teaching Hospital, Williama Heerleina Lindleya 4, 02-005 Warsaw, Poland https://orcid.org/0009-0008-7228-7086
  • Sebastian Iwaniuk University Clinical Centre of the Medical University of Warsaw, ul. Banacha 1A, 02-097 Warsaw, Poland https://orcid.org/0009-0000-9125-6172
  • Ignacy Maciejewski 5th Military Clinical Hospital in Cracow, Wrocławska 1/3, 30-901 Cracow, Poland https://orcid.org/0000-0002-0424-9095

DOI:

https://doi.org/10.12775/QS.2024.33.56178

Keywords

isotretinoin, acne vulgaris, adverse effects, retinoids

Abstract

Introduction and purpose: Isotretinoin (13-cis-Retinoic Acid), is a drug for moderate to severe acne that doesn't respond to other treatments. The purpose of this review was to present the mechanism of action, outcomes and adverse effects of isotretinoin.

Description of state of knowledge: Isotretinoin is a very lipophilic drug and is used in dermatology to treat acne vulgaris due to its inhibitory effect on sebaceous gland activity and proliferation. Isotretinoin can cause side effects across various body systems. Extra caution is advised for patients with lipid abnormalities or impaired liver function. For women of reproductive age, it's crucial to use contraception starting one month before, throughout, and for one month after isotretinoin treatment due to teratogenicity.

Conclusions: Oral isotretinoin is a highly effective acne treatment that helps prevent both physical scarring and psychological impacts associated with severe acne. Although generally associated with mild and reversible side effects, isotretinoin is teratogenic, which requires careful patient management.

References

Williams HC, Dellavalle RP, Garner S. Acne vulgaris [published correction appears in Lancet. 2012 Jan 28;379(9813):314]. Lancet. 2012;379(9813):361-372. doi:10.1016/S0140-6736(11)60321-8

O'Neill AM, Gallo RL. Host-microbiome interactions and recent progress into understanding the biology of acne vulgaris. Microbiome. 2018;6(1):177. Published 2018 Oct 2. doi:10.1186/s40168-018-0558-5

Svensson A, Ofenloch RF, Bruze M, et al. Prevalence of skin disease in a population-based sample of adults from five European countries. Br J Dermatol. 2018;178(5):1111-1118. doi:10.1111/bjd.16248

Thiboutot DM, Dréno B, Abanmi A, et al. Practical management of acne for clinicians: An international consensus from the Global Alliance to Improve Outcomes in Acne. J Am Acad Dermatol. 2018;78(2 Suppl 1):S1-S23.e1. doi:10.1016/j.jaad.2017.09.078

Bettoli V, Borghi A, Zauli S, et al. Maintenance therapy for acne vulgaris: efficacy of a 12-month treatment with adapalene-benzoyl peroxide after oral isotretinoin and a review of the literature. Dermatology. 2013;227(2):97-102. doi:10.1159/000350820

Rigopoulos D, Larios G, Katsambas AD. The role of isotretinoin in acne therapy: why not as first-line therapy? facts and controversies. Clin Dermatol. 2010;28(1):24-30. doi:10.1016/j.clindermatol.2009.03.005

Costa CS, Bagatin E, Martimbianco ALC, et al. Oral isotretinoin for acne. Cochrane Database Syst Rev. 2018;11(11):CD009435. Published 2018 Nov 24. doi:10.1002/14651858.CD009435.pub2

Dispenza MC, Wolpert EB, Gilliland KL, et al. Systemic isotretinoin therapy normalizes exaggerated TLR-2-mediated innate immune responses in acne patients. J Invest Dermatol. 2012;132(9):2198-2205. doi:10.1038/jid.2012.111

Brzezinski P, Borowska K, Chiriac A, Smigielski J. Adverse effects of isotretinoin: A large, retrospective review. Dermatol Ther. 2017;30(4):10.1111/dth.12483. doi:10.1111/dth.12483

Tkachenko E, Singer S, Sharma P, Barbieri J, Mostaghimi A. US Food and Drug Administration Reports of Pregnancy and Pregnancy-Related Adverse Events Associated With Isotretinoin. JAMA Dermatol. 2019;155(10):1175-1179. doi:10.1001/jamadermatol.2019.1388

Li C, Chen J, Wang W, Ai M, Zhang Q, Kuang L. Use of isotretinoin and risk of depression in patients with acne: a systematic review and meta-analysis [published correction appears in BMJ Open. 2019 Mar 15;9(3):e021549corr1. doi: 10.1136/bmjopen-2018-021549corr1]. BMJ Open. 2019;9(1):e021549. Published 2019 Jan 21. doi:10.1136/bmjopen-2018-021549

Lee YH, Scharnitz TP, Muscat J, Chen A, Gupta-Elera G, Kirby JS. Laboratory Monitoring During Isotretinoin Therapy for Acne: A Systematic Review and Meta-analysis [published correction appears in JAMA Dermatol. 2016 Jan;152(1):114. doi: 10.1001/jamadermatol.2015.6052]. JAMA Dermatol. 2016;152(1):35-44. doi:10.1001/jamadermatol.2015.3091

Rademaker M. Isotretinoin: dose, duration and relapse. What does 30 years of usage tell us?. Australas J Dermatol. 2013;54(3):157-162. doi:10.1111/j.1440-0960.2012.00947.x

Kurokawa I, Danby FW, Ju Q, et al. New developments in our understanding of acne pathogenesis and treatment. Exp Dermatol. 2009;18(10):821-832. doi:10.1111/j.1600-0625.2009.00890.x

Rocha MA, Costa CS, Bagatin E. Acne vulgaris: an inflammatory disease even before the onset of clinical lesions. Inflamm Allergy Drug Targets. 2014;13(3):162-167. doi:10.2174/1871528113666140606110024

Agak GW, Kao S, Ouyang K, et al. Phenotype and Antimicrobial Activity of Th17 Cells Induced by Propionibacterium acnes Strains Associated with Healthy and Acne Skin. J Invest Dermatol. 2018;138(2):316-324. doi:10.1016/j.jid.2017.07.842

Barbieri JS, Spaccarelli N, Margolis DJ, James WD. Approaches to limit systemic antibiotic use in acne: Systemic alternatives, emerging topical therapies, dietary modification, and laser and light-based treatments. J Am Acad Dermatol. 2019;80(2):538-549. doi:10.1016/j.jaad.2018.09.055

Khalil S, Bardawil T, Stephan C, et al. Retinoids: a journey from the molecular structures and mechanisms of action to clinical uses in dermatology and adverse effects. J Dermatolog Treat. 2017;28(8):684-696. doi:10.1080/09546634.2017.1309349

Mukherjee S, Date A, Patravale V, Korting HC, Roeder A, Weindl G. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clin Interv Aging. 2006;1(4):327-348. doi:10.2147/ciia.2006.1.4.327

Larange A, Cheroutre H. Retinoic Acid and Retinoic Acid Receptors as Pleiotropic Modulators of the Immune System. Annu Rev Immunol. 2016;34:369-394. doi:10.1146/annurev-immunol-041015-055427

Nelson AM, Zhao W, Gilliland KL, Zaenglein AL, Liu W, Thiboutot DM. Isotretinoin temporally regulates distinct sets of genes in patient skin. J Invest Dermatol. 2009;129(4):1038-1042. doi:10.1038/jid.2008.338

Cruz S, Vecerek N, Elbuluk N. Targeting Inflammation in Acne: Current Treatments and Future Prospects. Am J Clin Dermatol. 2023;24(5):681-694. doi:10.1007/s40257-023-00789-1

Melnik BC. Apoptosis May Explain the Pharmacological Mode of Action and Adverse Effects of Isotretinoin, Including Teratogenicity. Acta Derm Venereol. 2017;97(2):173-181. doi:10.2340/00015555-2535

Törmä H. Regulation of keratin expression by retinoids. Dermatoendocrinol. 2011;3(3):136-140. doi:10.4161/derm.3.3.15026

Nelson AM, Gilliland KL, Cong Z, Thiboutot DM. 13-cis Retinoic acid induces apoptosis and cell cycle arrest in human SEB-1 sebocytes. J Invest Dermatol. 2006;126(10):2178-2189. doi:10.1038/sj.jid.5700289

Melnik BC. p53: key conductor of all anti-acne therapies. J Transl Med. 2017;15(1):195. Published 2017 Sep 19. doi:10.1186/s12967-017-1297-2

Zhang YR, Zhao YQ, Huang JF. Retinoid-binding proteins: similar protein architectures bind similar ligands via completely different ways. PLoS One. 2012;7(5):e36772. doi:10.1371/journal.pone.0036772

Leyden JJ, Del Rosso JQ, Baum EW. The use of isotretinoin in the treatment of acne vulgaris: clinical considerations and future directions. J Clin Aesthet Dermatol. 2014;7(2 Suppl):S3-S21.

Vallerand IA, Lewinson RT, Farris MS, et al. Efficacy and adverse events of oral isotretinoin for acne: a systematic review. Br J Dermatol. 2018;178(1):76-85. doi:10.1111/bjd.15668

Barbieri JS, Shin DB, Wang S, Margolis DJ, Takeshita J. The clinical utility of laboratory monitoring during isotretinoin therapy for acne and changes to monitoring practices over time. J Am Acad Dermatol. 2020;82(1):72-79. doi:10.1016/j.jaad.2019.06.025

Melnik BC. Overexpression of p53 explains isotretinoin's teratogenicity. Exp Dermatol. 2018;27(1):91-93. doi:10.1111/exd.13420

Borghi A, Mantovani L, Minghetti S, Virgili A, Bettoli V. Acute acne flare following isotretinoin administration: potential protective role of low starting dose. Dermatology. 2009;218(2):178-180. doi:10.1159/000182270

Tekin NS, Ozdolap S, Sarikaya S, Keskin SI. Bone mineral density and bone turnover markers in patients receiving a single course of isotretinoin for nodulocystic acne. Int J Dermatol. 2008;47(6):622-625. doi:10.1111/j.1365-4632.2008.03534.x

Spring LK, Krakowski AC, Alam M, et al. Isotretinoin and Timing of Procedural Interventions: A Systematic Review With Consensus Recommendations. JAMA Dermatol. 2017;153(8):802-809. doi:10.1001/jamadermatol.2017.2077

Waldman A, Bolotin D, Arndt KA, et al. ASDS Guidelines Task Force: Consensus Recommendations Regarding the Safety of Lasers, Dermabrasion, Chemical Peels, Energy Devices, and Skin Surgery During and After Isotretinoin Use. Dermatol Surg. 2017;43(10):1249-1262. doi:10.1097/DSS.0000000000001166

Huang YC, Cheng YC. Isotretinoin treatment for acne and risk of depression: A systematic review and meta-analysis [published correction appears in J Am Acad Dermatol. 2018 Feb;78(2):431. doi: 10.1016/j.jaad.2017.10.041]. J Am Acad Dermatol. 2017;76(6):1068-1076.e9. doi:10.1016/j.jaad.2016.12.028

Lee SY, Jamal MM, Nguyen ET, Bechtold ML, Nguyen DL. Does exposure to isotretinoin increase the risk for the development of inflammatory bowel disease? A meta-analysis. Eur J Gastroenterol Hepatol. 2016;28(2):210-216. doi:10.1097/MEG.0000000000000496

Nagler AR, Milam EC, Orlow SJ. The use of oral antibiotics before isotretinoin therapy in patients with acne. J Am Acad Dermatol. 2016;74(2):273-279. doi:10.1016/j.jaad.2015.09.046

Rashtak S, Khaleghi S, Pittelkow MR, Larson JJ, Lahr BD, Murray JA. Isotretinoin exposure and risk of inflammatory bowel disease. JAMA Dermatol. 2014;150(12):1322-1326. doi:10.1001/jamadermatol.2014.1540

Öztürk S, Öztürk T, Ucak H, et al. Evaluation of ovarian reserve and function in female patients treated with oral isotretinoin for severe acne: an exploratory study. Cutan Ocul Toxicol. 2015;34(1):21-24. doi:10.3109/15569527.2014.888079

Ganceviciene R, Zouboulis CC. Isotretinoin: state of the art treatment for acne vulgaris. J Dtsch Dermatol Ges. 2010;8 Suppl 1:S47-S59. doi:10.1111/j.1610-0387.2009.07238.x

Downloads

  • PDF

Published

2024-11-27

How to Cite

1.
TYLCZYŃSKA, Kinga, TYLCZYŃSKA, Natalia, SKIBA, Jakub, SKIBA, Zuzanna, KOWALIK, Kinga, MICHALSKA, Maria, ZIELIŃSKA, Aleksandra, SZYPULSKI, Szymon, IWANIUK, Sebastian and MACIEJEWSKI, Ignacy. Outcomes and Adverse Effects of Isotretinoin in Acne Treatment: A Systematic Review. Quality in Sport. Online. 27 November 2024. Vol. 33, p. 56178. [Accessed 28 June 2025]. DOI 10.12775/QS.2024.33.56178.
  • ISO 690
  • ACM
  • ACS
  • APA
  • ABNT
  • Chicago
  • Harvard
  • IEEE
  • MLA
  • Turabian
  • Vancouver
Download Citation
  • Endnote/Zotero/Mendeley (RIS)
  • BibTeX

Issue

Vol. 33 (2024)

Section

Medical Sciences

License

Copyright (c) 2024 Kinga Tylczyńska, Natalia Tylczyńska, Jakub Skiba, Zuzanna Skiba, Kinga Kowalik, Maria Michalska, Aleksandra Zielińska, Szymon Szypulski, Sebastian Iwaniuk, Ignacy Maciejewski

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Stats

Number of views and downloads: 441
Number of citations: 0

Search

Search

Browse

  • Browse Author Index
  • Issue archive

User

User

Current Issue

  • Atom logo
  • RSS2 logo
  • RSS1 logo

Information

  • For Readers
  • For Authors
  • For Librarians

Newsletter

Subscribe Unsubscribe

Tags

Search using one of provided tags:

isotretinoin, acne vulgaris, adverse effects, retinoids
Up

Akademicka Platforma Czasopism

Najlepsze czasopisma naukowe i akademickie w jednym miejscu

apcz.umk.pl

Partners

  • Akademia Ignatianum w Krakowie
  • Akademickie Towarzystwo Andragogiczne
  • Fundacja Copernicus na rzecz Rozwoju Badań Naukowych
  • Instytut Historii im. Tadeusza Manteuffla Polskiej Akademii Nauk
  • Instytut Kultur Śródziemnomorskich i Orientalnych PAN
  • Instytut Tomistyczny
  • Karmelitański Instytut Duchowości w Krakowie
  • Ministerstwo Kultury i Dziedzictwa Narodowego
  • Państwowa Akademia Nauk Stosowanych w Krośnie
  • Państwowa Akademia Nauk Stosowanych we Włocławku
  • Państwowa Wyższa Szkoła Zawodowa im. Stanisława Pigonia w Krośnie
  • Polska Fundacja Przemysłu Kosmicznego
  • Polskie Towarzystwo Ekonomiczne
  • Polskie Towarzystwo Ludoznawcze
  • Towarzystwo Miłośników Torunia
  • Towarzystwo Naukowe w Toruniu
  • Uniwersytet im. Adama Mickiewicza w Poznaniu
  • Uniwersytet Komisji Edukacji Narodowej w Krakowie
  • Uniwersytet Mikołaja Kopernika
  • Uniwersytet w Białymstoku
  • Uniwersytet Warszawski
  • Wojewódzka Biblioteka Publiczna - Książnica Kopernikańska
  • Wyższe Seminarium Duchowne w Pelplinie / Wydawnictwo Diecezjalne „Bernardinum" w Pelplinie

© 2021- Nicolaus Copernicus University Accessibility statement Shop