Effect of oral 13-cis-retinoic acid at three dose levels on sustainable rates of sebum secretion and on acne

Stewart, Mary Ellen; Benoit, Allison M.; Stranieri, Anna M.; Rapini, Ronald P.; Strauss, John S.; Downing, Donald T.

doi:10.1016/s0190-9622(83)70061-7

Cited by 39 publications

(14 citation statements)

References 14 publications

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“…This effect is less than that reported for systemic treatment with isotretinoin, the gold standard in the treatment of acne vulgaris, as systemic isotretinoin has been shown to reduce sebum production by 60 to 90%, depending on the dose. Doses as low as 5 mg once a day have been shown to decrease sebum excretion by up to 50%, when using the Sebutape method [4,[13][14][15]. We saw similar decrease (64%) in sebum, as measured with the Sebutape method, in a single patient treated with 0.5 mg/kg of isotretinoin after 1 month of treatment (data not shown).…”

Section: Discussionsupporting

confidence: 66%

The 1,450‐nm diode laser reduces sebum production in facial skin: A possible mode of action of its effectiveness for the treatment of acne vulgaris

2007

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Background and Objectives: Over the last several years, several light-based systems have been employed for the treatment of acne vulgaris. The 1,450-nm diode laser has been shown to improve acne, and this has been suggested to be due to effects on sebaceous glands. However, an effect on sebum production has not been demonstrated. The objective of this study was to evaluate if the 1,450-nm diode laser indeed reduces sebum production. Study Design/Materials and Methods: Eight patients with a history of acne were recruited and treated with the 1,450-nm diode laser on the right side of the nose over a 6-week period, for a total of three treatments. Sebum production was quantified using the Sebutape method. Results: The number of sebum-producing follicles was reduced by 8.5 and 16.7% at weeks 4 and 6, respectively (P<0.05). A significant reduction in total collected sebum (À18%) was observed at week 6. Conclusion: This data suggests that the clinical effectiveness of the 1,450-nm diode laser may be based, at least in part, on its effects on sebaceous glands, with subsequent reduction in sebum production.

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Section: Discussionsupporting

confidence: 66%

The 1,450‐nm diode laser reduces sebum production in facial skin: A possible mode of action of its effectiveness for the treatment of acne vulgaris

2007

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“…This is consistent with the observations that sebum secretion can be markedly reduced by 13-cis RA as early as 2 weeks. 13,14 However, the sebaceous gland architecture returns to pre-treatment levels as early as 2 months after cessation of therapy and the rate of return is faster with the lower doses of isotretinoin. 15 Despite this observation, for unknown reasons, isotretinoin induces permanent remission of acne in a majority of cases.…”

Section: Discussionmentioning

confidence: 99%

Temporal changes in gene expression in the skin of patients treated with isotretinoin provide insight into its mechanism of action

Nelson¹,

Zhao²,

Gilliland³

et al. 2009

Dermato-Endocrinology

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Isotretinoin (13-cis RA) is the most potent agent in the treatment of acne. Insights into its mechanism of action can lead to drug discovery of alternative compounds with comparable efficacy but improved safety. The goal of this study is to compare the temporal changes in gene expression in the skin of acne patients after 1 week and 8 weeks of treatment with isotretinoin. Microarray analysis was performed on skin biopsies taken from eight acne patients prior to and at 8 weeks of treatment with isotretinoin. Results were compared with data obtained from seven acne patients biopsied at one week of treatment in a prior study. Distinctly different patterns of gene expression were noted. At 8 weeks, genes encoding extracellular matrix proteins were upregulated and numerous genes encoding lipid metabolizing enzymes were downregulated. At 1 week, genes encoding differentiation markers, tumor suppressors and serine proteases were upregulated. Only three genes were commonly downregulated. The temporal changes in gene expression in patient skin noted with isotretinoin substantiate many previously reported effects of isotretinoin and other retinoids, suggesting a model wherein isotretinoin induces apoptosis leading to reduced sebaceous gland size, decreased expression of lipid metabolizing enzymes and increased matrix remodeling during acne resolution.

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“…[20,23] Further studies culminated in the consensus dose of 1 mg/kg/day and the cumulative dose of 120-150 mg/kg. [1,[20][21][22][23][24][25][26][27][28][29][30] Studies were performed using varying doses ranging form 0.1-1 mg/kg/day. [1,[21][22][23][24][25][26][27][28][29][30] Eight Randomised Control Trials RCTs compared various isotretinoin dosage regimens ranging from 0.1 to 2.0 mg/kg/day.…”

Section: Effi Cacymentioning

confidence: 99%

Efficacy of low-dose isotretinoin in acne vulgaris

Sardana¹,

Garg²

2010

Indian J Dermatol Venereol Leprol

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Low-dose isotretinoin (0.5 mg/kg/day) is a mode of therapy for mild to moderate grades of acne. We analyzed the various trials of this mode of therapy with or without combination with topical agents. We also statistically analyzed the results, efficacy and relapse rates of standard therapy in comparison with the low-dose therapy. Our analysis of the data revealed that the efficacy and relapse rates of low-dose isotretinoin in mild to moderate grades of acne is comparable with the standard regimen (1 mg/kg/day), which is given in the severe grade of acne vulgaris. Thus, the grade of acne vulgaris should dictate the dose of administration of isotretinoin and the standard dose of 1 mg/kg/day is an unnecessary overtreatment for mild to moderate grades of acne.

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Effect of oral 13-cis-retinoic acid at three dose levels on sustainable rates of sebum secretion and on acne

Cited by 39 publications

References 14 publications

The 1,450‐nm diode laser reduces sebum production in facial skin: A possible mode of action of its effectiveness for the treatment of acne vulgaris

The 1,450‐nm diode laser reduces sebum production in facial skin: A possible mode of action of its effectiveness for the treatment of acne vulgaris

Temporal changes in gene expression in the skin of patients treated with isotretinoin provide insight into its mechanism of action

Efficacy of low-dose isotretinoin in acne vulgaris

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