704
Views
19
CrossRef citations to date
0
Altmetric
Expert Opinion

Challenges and Solutions in Oral Isotretinoin in Acne: Reflections on 35 Years of Experience

ORCID Icon, ORCID Icon, & ORCID Icon
Pages 943-951 | Published online: 30 Dec 2019

References

  • Bhate K, Williams HC. Epidemiology of acne vulgaris. Br J Dermatol. 2013;168(3):474–485. doi:10.1111/bjd.2013.168.issue-323210645
  • American Academy of Dermatology [Website]. Available from: https://www.aad.org/public/diseases/acne-and-rosacea/acne#overview. Accessed 731, 2019.
  • Dréno B, Layton A, Zouboulis CC, et al. Adult female acne: a new paradigm. JEADV. 2013;27:1063–1070. doi:10.1111/jdv.1206123302006
  • Tan J, Kang S, Leyden J. Prevalence and Risk factors of acne scarring among patients consulting dermatologists in the USA. J Drugs Dermatol. 2017;16(2):97–102.28300850
  • Dalgard F, Gieler U, Tomas-Aragones L, et al. The psychological burden of skin diseases: a cross-sectional multicenter study among dermatological out-patients in 13 European countries. J Invest Dermatol. 2015;135(4):984–991. doi:10.1038/jid.2014.53025521458
  • Guerra-Tapia A, Asensio Martínez Á, García Campayo J. The emotional impact of skin diseases. Actas Dermosifiliogr. 2015;106(9):699–702. doi:10.1016/j.ad.2015.06.00226227881
  • Nast A, Dreno B, Bettoli V, et al. European Evidence-based (S3) guideline for the treatment of acne – update 2016. J Eur Acad Dermatol Venereol. 2016;30:1261. doi:10.1111/jdv.1377627514932
  • Thiboutot D, Dreno 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:S1–S23. doi:10.1016/j.jaad.2017.09.07829127053
  • Hazen PG, Carney JF, Walker AE, Stewart JJ. Depression–a side effect of 13-cis-retinoic acid therapy. J Am Acad Dermatol. 1983;9(2):278–279. doi:10.1016/S0190-9622(83)80154-6
  • Hodak E, Gadoth N, David M, Sandbank M. Muscle damage induced by isotretinoin. Br Med J (Clin Res Ed). 1986;293(6544):425–426. doi:10.1136/bmj.293.6544.425
  • 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. BMJ Open. 2019;9(1):e021549. doi:10.1136/bmjopen-2018-021549
  • Asai Y, Baibergenova A, Dutil M, et al. Management of acne: Canadian clinical practice guideline. CMAJ. 2016;188(2):118–126. doi:10.1503/cmaj.14066526573753
  • Ribera M, Guerra A, Moreno-Giménez JC, de Lucas R, Pérez-López M. Treatment of acne in daily clinical practice: an opinion poll among Spanish dermatologists. Actas Dermosifiliogr. 2011;102(2):121–131. doi:10.1016/j.ad.2010.07.00321342680
  • Guerra-Tapia A. Effects of benzoyl peroxide 5% clindamycin combination gel versus adapalene 0.1% on quality of life in patients with mild to moderate acne vulgaris: a randomized single-blind study. J Drugs Dermatol. 2012;11(6):714–722.22648218
  • Zouboulis CC, Piquero-Martin J. Update and future of systemic acne treatment. Dermatology. 2003;206:37–53. doi:10.1159/00006782112566804
  • Dréno B. Bacteriological resistance in acne: a call to action. Eur J Dermatol. 2016;26(2):127–132. doi:10.1684/ejd.2015.268526711531
  • Herane MI. Resistencia bacteriana In: Kaminsky A y Flórez-White M; cols, editors. Acne: Un Enfoque Global. 3rd ed Ed CILAD; 2015:206–220.
  • Peck GL, Olsen TG, Yoder FW, et al. Prolonged remissions of cystic and conglobate acne with 13 cis retinoic acid. N Engl J Med. 1979;300(7):329–333. doi:10.1056/NEJM197902153000701153472
  • Ozolins M, Eady EA, Avery A, et al. Randomised controlled multiple treatment comparison to provide a cost-effectiveness rationale for the selection of antimicrobial therapy in acne. Health Technol Assess. 2005;9(1):iii–212. doi:10.3310/hta9010
  • Nagler AR, Milam EC, Orlow SJ. The use of oral antibiotics before isotretinoin therapy in patients with acne. J Am Acad Dermatol. 2016;74:273–279. doi:10.1016/j.jaad.2015.09.04626525749
  • Piquero-Martin J, Misticone S, Piquero-Casals V, Piquero-Casals J. Topic therapy-mini isotretinoin doses vs topic therapy-systemic antibiotics in the moderate acne patients. Ann Dermatol Venereol. 2002;129:S382.
  • Barbieri JS, Bhate K, Hartnett KP, et al. Trend in oral antibiotic prescription in dermatology, 2008 to 2016. JAMA Dermatol. 2019;155:290. doi:10.1001/jamadermatol.2018.494430649187
  • Guerra Tapia A, Camacho FM. Aspectos psíquicos del acné. Influencia Terapéutica. Monogr Dermatol. 2008;21:11–123.
  • Gupta MA, Gupta AK. Depression and suicidal ideation in dermatology patients with acne, alopecia areata, atopic dermatitis and psoriasis. Br J Dermatol. 1998;139(5):846–850. doi:10.1046/j.1365-2133.1998.02511.x9892952
  • Azoulay L, Blais L, Koren G, LeLorier J, Bérard A. Isotretinoin and the risk of depression in patients with acne vulgaris: a case-crossover study. J Clin Psychiatry. 2008;69(4):526–532. doi:10.4088/JCP.v69n040318363422
  • Bremner JD, Shearer KD, McCaffery PJ. Retinoic acid and affective disorders: the evidence for an association. J Clin Psychiatry. 2012;73(1):37–50. doi:10.4088/JCP.10r05993
  • Kaymak Y, Kalay M, Ilter N, Taner E. Incidence of depression related to isotretinoin treatment in 100 acne vulgaris patients. Psychol Rep. 2006;99(3):897–906. doi:10.2466/PR0.99.7.897-90617305209
  • Strahan JE, Raimer S. Isotretinoin and the controversy of psychiatric adverse effects. Int J Dermatol. 2006;45(7):789–799. doi:10.1111/ijd.2006.45.issue-716863513
  • Marqueling AL, Zane LT. Depression and suicidal behavior in acne patients treated with isotretinoin: a systematic review. Semin Cutan Med Surg. 2007;26(4):210–220. doi:10.1016/j.sder.2008.03.00518395669
  • Hahm BJ, Min SU, Yoon MY, et al. Changes of psychiatric parameters and their relationships by oral isotretinoin in acne patients. J Dermatol. 2009;36(5):255–261. doi:10.1111/j.1346-8138.2009.00635.x19382995
  • Gnanaraj P, Karthikeyan S, Narasimhan M, Rajagopalan V. Decrease in “Hamilton rating scale for depression” following isotretinoin therapy in acne: an open-label prospective study. Indian J Dermatol. 2015;60(5):461–464. doi:10.4103/0019-5154.16435826538692
  • Singer S, Tkachenko E, Sharma P, Barbieri J, Mostaghimi A. Psychiatric adverse events in patients taking isotretinoin as reported in a food and drug administration database from 1997 to 2017. JAMA Dermatol. 2019;3.
  • Huang YC, Cheng YC. Isotretinoin treatment for acne and risk of depression: a systematic review and meta-analysis. J Am Acad Dermatol. 2017;76(6):1068–1076.e9. doi:10.1016/j.jaad.2016.12.02828291553
  • Alomar A, Guerra Tapia A, Perulero N, Badía X, Canals L, Álvarez C. Desarrollo de un cuestionario de evaluación de la satisfacción con el tratamiento en pacientes con acné. Actas Dermosifiliogr. 2004;95(8):491–495. (). doi:10.1016/S0001-7310(04)76865-9
  • Cañete A, Cano E, Muñoz-Chápuli R, Carmona R. Role of vitamin A/retinoic acid in regulation of embryonic and adult hematopoiesis. Nutrients. 2017;9(2):159. doi:10.3390/nu9020159
  • Costa CS, Bagatin E, Martimbianco ALC, et al. Oral isotretinoin for acne (Review). Cochrane Database Syst Rev. 2018;11:Art. No.: CD009435.
  • Sonthalia S, Sahaya K, Arora R, et al. Nocebo effect in dermatology. Indian J Dermatol Venereol Leprol. 2015;81(3):242–250. doi:10.4103/0378-6323.15557325900939
  • Holst H, Muhari-stark E, Lava SA. Teratogenicity of systemic isotretinoin. Minerva Pediatr. 2018;70:107.29363297
  • Kowitvanichkanont T, Driscoll T. A comparative review of the isotretinoin pregnancy risk management programs across four continents. Int J Dermatol. 2018;57(9):1035–1046. doi:10.1111/ijd.1395029508918
  • Thiboutot D, Gollnick H, Bettoli V, et al. Oral isotretinoin and pregnancy prevention programmes. Br J Dermatol. 2012;166:466. doi:10.1111/j.1365-2133.2011.10686.x21985025
  • Shin J, Cheettham TC, Wong L, et al. The impact of the iPLEDGE program on isotretinoin fetal exposure in an integrated health care system. J Am Acad Dermatol. 2011;65:1117. doi:10.1016/j.jaad.2010.09.01721565419
  • Mori WS, Houston N, Moreau JF, et al. Personal burden of isotretinoin therapy and willingness to pay for electronic follow-up visits. JAMA Dermatol. 2016;152(3):338–340. doi:10.1001/jamadermatol.2015.476326720269
  • Charrow A, Xia FD, Lu J, Waul M, Joyce C, Mostaghimi A. Differences in isotretinoin start, interruption, and early termination across race and sex in the iPLEDGE era. PLoS One. 2019;14(3):e0210445. doi:10.1371/journal.pone.021044530913210
  • European Medicines Agency. Updated measures for pregnancy prevention during retinoid use. Available from: https://www.ema.europa.eu/medicines/human/referrals/retinoid-containing-medicinal-products. Accessed 107, 2019.
  • Ward A, Brogden RN, Heel RC, Speight TM, Avery GS. Isotretinoin. A review of its pharmacological properties and therapeutic efficacy in acne and other skin disorders. Drugs. 1984;28(1):6–37. doi:10.2165/00003495-198428010-000026235105
  • Del Rosso JQ. Clinical relevance of skin barrier changes associated with the use of oral isotretinoin: the importance of barrier repair therapy in patient management. J Drug Dermatol. 2013;12:626.
  • Elias PM. Epidermal effects of retinoids: supramolecular observations and clinical implications. J Am Acad Dermatol. 1986;15(4 Pt 2):797–809. doi:10.1016/S0190-9622(86)70236-32430000
  • Ornelas J, Rosamilia L, Larsen L, et al. Objective assessment of isotretinoin-associated cheilitis: isotretinoin Cheilitis Grading Scale. J Dermatol Treat. 2016;27:153. doi:10.3109/09546634.2015.1086477
  • Vallerand IA, Lewinson RT, Farris MS, et al. Effficacy and adverse events of oral isotretinoin for acne: a systematic review. Br J Dermatol. 2018;178:76. doi:10.1111/bjd.1566828542914
  • Brelsford M, Beute TC. Preventing and managing the side effects of isotretinoin. Semin Cutan Med Surg. 2008;27(3):197–206. doi:10.1016/j.sder.2008.07.00218786498
  • Layton A. The use of isotretinoin in acne. Dermatoendocrinol. 2009;1(3):162–169. doi:10.4161/derm.1.3.936420436884
  • Crockett SD, Porter CQ, Martin CF, Sandler RS, Kappelman MD. Isotretinoin use and the risk of inflammatory bowel disease: a case-control study. Am J Gastroenterol. 2010;105(9):1986–1993. doi:10.1038/ajg.2010.12420354506
  • 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;28:210. doi:10.1097/MEG.000000000000049626545085
  • Etminan M, Bird ST, Delaney JA, Bressler B, Brophy JM. Isotretinoin and risk for inflammatory bowel disease: a nested case-control study and meta-analysis of published and unpublished data. JAMA Dermatol. 2013;149(2):216–220. doi:10.1001/jamadermatol.2013.134423426479
  • Roche. Summary of product characteristics, isotretinoin 10 mg capsules. Available from: https://www.medicines.org.uk/emc/product/1114/smpc. Accessed 107, 2019.
  • 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. JAMA Dermatol. 2016;152:35. doi:10.1001/jamadermatol.2015.309126630323
  • Bauer LB, Ornelas JN, Elston DM, Alikhan A. Isotretinoin: controversies, facts, and recommendations. Expert Rev Clin Pharmacol. 2016;9:1435. doi:10.1080/17512433.2016.121362927414637
  • Kaymak Y. Creatine phosphokinase values during isotretinoin treatment for acne. Int J Dermatol. 2008;47:398. doi:10.1111/j.1365-4632.2008.03491.x18377609
  • DiGiovanna JJ. Isotretinoin effects on bone. J Am Acad Dermatol. 2001;45(5):S176–82. doi:10.1067/mjd.2001.11372111606950
  • DiGiovanna JJ, Langman CB, Tschen EH, et al. Effect of a single course of isotretinoin therapy on bone mineral density in adolescent patients with severe, recalcitrant, nodular acne. J Am Acad Dermatol. 2004;51(5):709–717. doi:10.1016/j.jaad.2004.04.03215523348
  • Vestergaard P, Rejnmark L, Mosekilde L. High-dose treatment with vitamin A analogues and risk of fractures. Arch Dermatol. 2010;146(5):478–482. doi:10.1001/archdermatol.2010.5920479294
  • Kocijancic M 1. 13-cis-retinoic acid and bone density. Int J Dermatol. 1995;34(10):733–734. doi:10.1111/ijd.1995.34.issue-108537167
  • 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. 2019. doi:10.1016/j.jaad.2019.06.025
  • 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;218:178. doi:10.1159/00018227019060474
  • González Guerra E, Guerra Tapia A. Application of cosmeceuticals to dermatological practice. Monogr Dermatol. 2012;25:63–67. 0214–4735.
  • De Lucas R, Moreno-Arias G, Pérez-López M, et al. Adherence to drug treatments and adjuvant barrier repair therapies are key factors for clinical improvement in mild to moderate acne: the ACTUO observational prospective multicenter cohort trial in 643 patients. BMC Dermatol. 2015;15:17. doi:10.1186/s12895-015-0036-826361978
  • Araviiskaia E, Dréno B. The role of topical dermocosmetics in acne vulgaris. JEADV. 2016;30:926–935. doi:10.1111/jdv.1357926916232
  • Mc Donald HP, Garg AX, Haynes RB. Interventions to enhance patient adherence to medication prescriptions: scientific review. JAMA. 2002;288:2868–2879. doi:10.1001/jama.288.22.286812472329
  • Dall’oglio F, Tedeschi A, Fabbrocini G, Veraldi S, Picardo M, Micali G. Cosmetics for acne: indications and recommendations for an evidence-based approach. G Ital Dermatol Venereol. 2015;150(1):1–11.25315288
  • Elias PM, Fritsch PO, Lampe M, et al. Retinoid effects on epidermal structure, differentiation, and permeability. Lab Invest. 1981;44(6):531–540.6939940
  • Del Rosso JQ, Levin J. The clinical relevance of maintaining the functional integrity of the stratum corneum in both healthy and diseased skin. J Clin Aesthet Dermatol. 2011;4(9):22–42.
  • Herane MI, Fuenzalida H, Zegpi E, et al. Specific gel-cream as adjuvant to oral isotretinoin improved hydration and prevented TEWL increase-a double-blind, randomized, placebo-controlled study. J Cosm Dermatol. 2009;8:181–185. doi:10.1111/j.1473-2165.2009.00455.x
  • Melnik B, Kinner T, Plewig G. influence of oral isotretinoin treatment on the composition of comedonal lipids: implications for comedogenesis in acne vulgaris. Arch Dermatol Res. 1988;280(2):97–102. doi:10.1007/BF004177122969220
  • Greene RS, Downing DT, Pochi PE, et al. Anatomical variation in the amount and composition of human skin surface lipid. J Invest Dermatol. 1970;54(3):240–247. doi:10.1111/1523-1747.ep122803185436951
  • Basak PY, Cetin ES, Gurses I, et al. The effects of systemic isotretinoin and antibiotic therapy on the microbial floras in patients with acne vulgaris. JEADV. 2013;273:332–336.
  • Ch L G, Nopakun N, Micali G, et al. Meeting the challenges of acne treatment in Asian patients: a review of the role of dermocosmetics as adjunctive therapy. J Cutan Aesthet Surg. 2016;9:85–92. doi:10.4103/0974-2077.18404327398008
  • Capitanio B, Sinagra JL, Weller RB, et al. Randomized controlled study of a cosmetic treatment for mild acne. Clin Exp Dermatol. 2012;37(4):346–349. doi:10.1111/ced.2012.37.issue-422369176
  • 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.2017.207728658462
  • 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.000000000000116628498204