Efficacy and adverse events of oral isotretinoin for acne: a systematic review

  title={Efficacy and adverse events of oral isotretinoin for acne: a systematic review},
  author={I A Vallerand and Ryan T. Lewinson and Megan S. Farris and Christopher D. Sibley and Michele L. Ramien and Andrew G. M. Bulloch and Scott B. Patten},
  journal={British Journal of Dermatology},
Despite many years of clinical use of isotretinoin, a comprehensive review of evidence for isotretinoin therapy in patients with acne is lacking. We searched MEDLINE, Embase, Cochrane Central, relevant web pages and bibliographies for randomized controlled trials in acne evaluating isotretinoin vs. control (placebo or other therapy). Data were extracted and summarized descriptively. Eleven trials were identified (total 760 patients randomized), containing mostly men. Mean treatment ages ranged… 

Systematic review of low‐dose isotretinoin for treatment of acne vulgaris: Focus on indication, dosage, regimen, efficacy, safety, satisfaction, and follow up, based on clinical studies

This systematic review aimed to sum up the results of clinical trials regarding indications, dosage, prescription protocol, effectiveness, side effects, patient satisfaction, recurrence rate, and follow‐up period of low dose isotretinoin in treatment of acne.

Oral isotretinoin for acne: a complete overview

Oral isotretinoin represents a valid therapeutic alternative in treating severe and mild-to-moderate acne lesions, also reducing scarring damage, and should be considered in order to obtain optimal results.

The use of isotretinoin for acne – an update on optimal dosing, surveillance, and adverse effects

Oral isotretinoin is the unique treatment for cure or prolonged remission for moderate and severe acne, preventing psychosocial impact and scars, and no other therapeutic option, even topicals combined to oral antibiotics accomplish same results.

Use of isotretinoin and risk of depression in patients with acne: a systematic review and meta-analysis

An association of the use of isotretinoin in patients with acne with significantly improved depression symptoms is suggested, and future randomised controlled trials are needed to verify the present findings.

Is the effect worth the risk? - The most common complaints during oral isotretinoin anti-acne therapy and controversies around its adverse effects

All of the most common isotretinoin side effects are usually mild and dose-dependent, however, their prevalence is very high, and in spite of the previous data, the risk of inflammatory bowel disease is probably not increased in patients isot retinoin exposed.

Investigation of Relapse Rate and Factors Affecting Relapse after Oral Isotretinoin Treatment in Patients with Acne Vulgaris.

To prevent relapse in patients with acne using oral isotretinoin, it is of great importance to continue the treatment until complete clinical improvement, and extend the treatment for at least one more month regardless of the cumulative dose.

Prevalence and associated risk factors of acne relapse among Saudi acne vulgaris patients using isotretinoin

Isotretinoin plus 420 nm intense pulsed light versus isotretinoin alone for the treatment of acne vulgaris: a randomized, controlled study of efficacy, safety, and patient satisfaction in Chinese subjects

Compared with isot retinoin alone, isotretinoin and 420 nm IPL combined treatment proved to be more effective within limited treatment duration and it was well-tolerated and the patients’ satisfaction was high.

Indication, Contraindication, Complication and Monitoring of Isotretinoin

Evidence from the literature suggests that isotretinoin is the effective medication in treatment of acne and low dose of isot retinoin does not cause any complication, and evidence-based guidelines and strategies for safety and efficacy of isotRetinoin can be developed by further clinical research and trials.



No association found between patients receiving isotretinoin for acne and the development of depression in a Canadian prospective cohort.

Isotretinoin does not appear to be associated with the development of depression, and denying patients with significant acne an effective medication for fear of developing depression may not be indicated at this point in time.

Does exposure to isotretinoin increase the risk for the development of inflammatory bowel disease? A meta-analysis

Isotretinoin exposure is not associated with an increased risk of developing both ulcerative colitis and Crohn’s disease.

Clinical and microbiological comparisons of isotretinoin vs. tetracycline in acne vulgaris.

Antibiotic treatment was found to be a good alternative to isot retinoin, regardless of the presence of antibiotic-resistant P. acnes, although isotretinoin had a better effect, with prolonged remission after treatment.

The cost-effectiveness of isotretinoin in the treatment of acne. Part 1. A meta-analysis of effectiveness literature.

The results of this meta-analysis support the continued use of isotretinoin in the treatment of acne and are important in the field of pharmaceutical benefit management where they will assist in the optimal management of this health condition.

Isotretinoin versus weekly pulse dose azithromycin in the treatment of acne-a comparative study

Both isot retinoin and azithromycin can be useful for the treatment of moderate and severe acne but isotretinoin appears to be superior to weekly pulse dose of azithsromycin.

Hemodialysis-Related Nodulocystic Acne Treated with Isotretinoin

It is demonstrated that the small dose of isotretinoin effectively treated nodulocystic acne of hemodialysis patients and the side effects were mild, which suggests that isot retinoin may be the treatment of choice for nodulocytesstic acne in end-stage renal disease patients with renal replacement therapy.

Isotretinoin and Tetracycline in the Management of Severe Nodulocystic Acne

Long‐term followup, 8 months after discontinuation of the study, showed a prolonged significant remission of acne in the isotretinoin group but not in the tetracycline group, a statistically significant difference in the two treatment groups, at 24 weeks.

Comparison of combined azelaic acid cream plus oral minocycline with oral isotretinoin in severe acne.

The combination of topical 20% AA cream and oral minocycline is an highly effective treatment in severe forms of acne and can be regarded as a valuable alternative in patients for whom isot retinoin is not indicated, who do not wish to use or can not tolerate isotretinoin therapy and particularly in female acne patients of child-bearing potential.

Safety and side effects of the acne drug, oral isotretinoin.

The most common adverse events, observed during treatment, are mucocutaneous and ophthalmological and laboratory abnormalities and effects in the nervous, musculoskeletal, gastrointestinal, pulmonary and other systems have been described.