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

Bagatin, Ediléia; Costa, Caroline Sousa

doi:10.1080/17512433.2020.1796637

Cited by 87 publications

(99 citation statements)

References 132 publications

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“…Like other retinoates, isotretinoin's lipophilic characteristic leads to a wide range of absorption levels when consumed without food. When taking them with food, the bioavailability (measured as mean maximum plasma concentration and the area under the 'plasma concentration-time' curve) increases, and the variability decreases [9,10].…”

Section: Pharmacokineticsmentioning

confidence: 99%

“…Retinoid can induce or suppress the expression of various genes and play an essential role in the cellular process. The mechanism of action includes normalizing follicular hyperkeratinization, decreasing the production of cytokeratin 1, 10, 14, filaggrin, matrix metallopeptidases (MMPs), and toll-like receptor 2 (TLR-2), and increasing the production of cytokeratin 7, 13, 19, laminina B1, and IL-1 [9,20].…”

Section: Isotretinoin Mechanism Of Actionmentioning

confidence: 99%

“…Therefore, retinoid contributes to decreasing corneocytes' adhesion, supporting cellular proliferation and follicular renewal, induction of cell apoptosis, and immune regulation [9].…”

Section: Isotretinoin Mechanism Of Actionmentioning

confidence: 99%

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Isotretinoin for Treating Acne Vulgaris

Sitohang

2021

Int J App Pharm

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Acne vulgaris (AV) occurs in more than 80% of dermatological cases in adolescents and young adults and affects the quality of life. Oral isotretinoin, a metabolite product of vitamin A, is well-known to be the most effective treatment for severe nodulocystic AV and moderate AV that does not respond to other therapeutic modalities. Thus, this literature review was conducted to explain the mechanism of action, effectiveness, contraindications, side effects, and safety of oral isotretinoin in AV, which provided essential information for dermatologists. Furthermore, isotretinoin is the only treatment modality that has implications for the entire pathogenesis of acne. It contributes to decreasing corneocytes’ adhesion, supporting cellular proliferation and follicular renewal, induction of cell apoptosis, and immune regulation. The effectiveness of AV therapy with isotretinoin has expanded as it is also indicated for moderate to severe AV that does not respond well to topical combination therapy or systemic antibiotics. However, isotretinoin is included in Category X drugs and may induce many side effects from mucocutaneous effects to teratogenicity. From this extensive literature review, it can be concluded that isotretinoin is one of the treatment modalities for acne with good effectivity due to its mechanism of actions that affect the entire acne pathogenesis. Considering the various side effects of isotretinoin, its use requires adequate clinical assessment and monitoring by a dermatologist.

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Section: Pharmacokineticsmentioning

confidence: 99%

Section: Isotretinoin Mechanism Of Actionmentioning

confidence: 99%

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Isotretinoin for Treating Acne Vulgaris

Sitohang

2021

Int J App Pharm

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“…Isotretinoin acts on the sebaceous glands, reducing their activity; it promotes normalization of keratinization and of tissue matrix metalloproteinase; and it reduces inflammation and Cutibacterium acnes growth. 2 Cheilitis, dry skin, erythema, itching, peeling, bruising, eczematous reactions, conjunctivitis, dry eyes, and eyelid inflammation are the most common adverse effects ([1/10). 2 However, as reported by Cunningham et al, 1 we also describe in our experience the involvement of the genital region, although patients voluntarily do not report such symptoms.…”

mentioning

confidence: 99%

“…2 Cheilitis, dry skin, erythema, itching, peeling, bruising, eczematous reactions, conjunctivitis, dry eyes, and eyelid inflammation are the most common adverse effects ([1/10). 2 However, as reported by Cunningham et al, 1 we also describe in our experience the involvement of the genital region, although patients voluntarily do not report such symptoms. 1 Forty patients in treatment with only isotretinoin (26 female and 14 male patients; mean age, 23.1 years) at our outpatient specific service for acne from February to August 2020 were questioned for the appearance of any effects on the genital area.…”

mentioning

confidence: 99%