Oral Vitamin A for Acne Management: A Possible Substitute for Isotretinoin

Cook, Madison; Perche, Patrick O; Feldman, Steven R.

doi:10.36849/jdd.6781

Cited by 7 publications

(7 citation statements)

References 5 publications

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“…In a 12-week placebo-controlled trial, Anderson and Stokoe found that clinician-assessed improvement and improvement based on photographs judged by a panel were equivalent between vitamin A (150 000 IU/d) and placebo. Though no adverse effects were reported in this trial, vitamin A has the potential for teratogenicity, neuropsychiatric disturbances, and mucocutaneous adverse effects; the high doses required for acne therapy increase the likelihood of developing these adverse effects …”

Section: Resultsmentioning

confidence: 99%

“…Similar to isotretinoin, vitamin A addresses pathogenic factors that contribute to the development of acne by decreasing sebaceous gland activity and inhibiting comedogenesis. However, randomized clinical trials to support the role of vitamin A in the treatment of acne are generally lacking, with much of the evidence base consisting of case reports and small case series published over 60 years ago . In a 12-week placebo-controlled trial, Anderson and Stokoe found that clinician-assessed improvement and improvement based on photographs judged by a panel were equivalent between vitamin A (150 000 IU/d) and placebo.…”

Section: Resultsmentioning

confidence: 99%

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Safety and Effectiveness of Oral Nutraceuticals for Treating Acne

Shields,

Ly,

Wafae

et al. 2023

JAMA Dermatol

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ImportancePatients with acne are interested in nutraceuticals as a potential treatment option. However, there is uncertainty regarding the efficacy and safety of these products.ObjectiveTo evaluate the evidence for oral nutraceuticals in the treatment of acne.Evidence ReviewThe PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science databases were searched from inception through January 30, 2023, to identify randomized clinical trials evaluating oral nutraceutical interventions (ie, vitamins and minerals, botanical extracts, prebiotics, and probiotics) in individuals with acne. Clinician-reported outcomes (eg, investigator global assessment, lesion counts), patient-reported outcomes (eg, quality of life), and adverse events were extracted from the included studies. The quality of evidence was assessed using the Cochrane Risk of Bias checklist tool for randomized clinical trials. Based on the Risk of Bias tool, articles were converted to Agency for Healthcare Research and Quality standards of good, fair, or poor quality.FindingsA total of 2582 abstracts were identified in the database search, 42 of which met inclusion criteria (a total of 3346 participants). Studies of fair or good quality showed the potential benefit of vitamins B5 and D, botanical extracts (green tea), probiotics, and ω-3 fatty acids in the treatment of acne. These interventions were most frequently associated with decreased lesion counts or improved investigator global assessment scores. Adverse effects were rare for most of the therapies evaluated, but gastrointestinal tract adverse effects were reported for zinc therapy.Conclusions and RelevanceThis systematic review suggests a possible role for nutraceutical supplements in the treatment of acne. Physicians should be prepared to discuss the evidence regarding the potential role of nutraceuticals with patients. Many studies were of small size, and future research should focus on larger randomized clinical trials to assess the utility of nutraceuticals in the treatment of acne.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Safety and Effectiveness of Oral Nutraceuticals for Treating Acne

Shields,

Ly,

Wafae

et al. 2023

JAMA Dermatol

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“… 114 Because of the difficulty of accessing ISO, patients may turn to over-The-counter dietary vitamin A supplements. 115 Cook et al 116 proved that at doses of 50,000–300,000 IU daily, vitamin A probably supply a second choice for acne management when ISO is unavailable. However, vitamin A was not considered safe enough to be reused because it was easily available and could not be strictly monitored.…”

Section: Discussionmentioning

confidence: 99%

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

Ding¹,

Zheng²,

Jin³

2023

CCID

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Isotretinoin (ISO) is a powerful vitamin A derivative that offers the potential for treatment of permanent remission of acne; however, its potential side effects on both physiological and psychological aspects limit its application. This article reviews the side effects of ISO from physiological and psychological aspects in detail, to better screen the suitable population of ISO and improve the efficiency of clinical treatment. Our findings indicate that ISO may cause teratogenicity, skin reactions, ocular reactions, changes in blood indicators, and occasional acne fulminans. To optimize clinical treatment, more attention should be paid to identifying the specific conditions under which these reactions occur, how severe they are, and how they subside to alleviate patient concerns. Regarding the controversial issue of psychological side effects caused by ISO, researchers should shift their focus to the psychological problems that acne itself may cause.

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“…Appropriate levels of vitamin A are necessary to prevent symptoms of VAD, such as night blindness, dry skin, keratomalacia, and immunosuppression. One of the most common uses of prescribed vitamin A isotretinoin is a vitamin A-derived medication administered orally over months for treating severe cystic acne; however, it has a teratogenic association [ 8 , 27 ]. Many individuals may start medication for their acne without realizing the teratogenic effects that it will have on their future child.…”

Section: Reviewmentioning

confidence: 99%

Vitamin A-Mediated Birth Defects: A Narrative Review

Abadie,

Staples,

Lauck

et al. 2023

Cureus

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Vitamin A deficiency (VAD) or excess in expectant mothers can result in fetal abnormalities such as night blindness, bone anomalies, or epithelial cell problems. In contrast, excessive vitamin A in pregnancy can precipitate fetal central nervous system deformities. During pregnancy, a pregnant woman should monitor her vitamin A intake ensuring she gets the recommended dosage, but also ensuring she doesn't exceed the recommended dosage, because either one can result in teratogenicity in the fetus. The widespread and unregulated use of multivitamins and supplements makes consuming doses greater than the recommended quantity more common in developed countries. While vitamin A excess is more common in developed countries, deficiency is most prevalent in developing countries. With proper maintenance, regulation, and education about VAD and excess, a pregnant mother can diminish potential harm to her fetus and potential teratogenic risks.

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Oral Vitamin A for Acne Management: A Possible Substitute for Isotretinoin

Cited by 7 publications

References 5 publications

Safety and Effectiveness of Oral Nutraceuticals for Treating Acne

Safety and Effectiveness of Oral Nutraceuticals for Treating Acne

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

Vitamin A-Mediated Birth Defects: A Narrative Review

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