China
Africa
Explore chapters and articles related to this topic
Nanoparticle-Stabilized Liposomes as an Effective Bio-Active Drug Molecule Delivery for Acne Treatment
Published in Namrita Lall, Medicinal Plants for Cosmetics, Health and Diseases, 2022
Catherine Wilkinson, Marco N. De Canha, Namrita Lall
Isotretinoin is one of the most effective acne treatments available, due to its ability to act on multiple acne-causing targets. Isotretinoin treatment is associated with the lowest rate of relapse and it is most often used for severe acne where nodules and cysts are present. However, in some cases, lower dosages have been prescribed for moderately severe acne. A major downfall of isotretinoin is its numerous, highly significant side effects, including increased serum lipids, photosensitivity, hyperlipidaemia, cheilitis, dry skin and mucous membranes, increased chance of cutaneous S. aureus infections, epistaxis, pseudotumor cerebri, teratogenicity, temporary worsening of lesions and myalgias (Simonart, 2012).
Acne
Published in Samar Razaq, Difficult Cases in Primary Care, 2021
Which of the following statements is true? Josh should be advised that his acne is not severe enough to warrant any treatment and that he should wait for it to settle on its own.Isotretinoin is contraindicated in Josh because of his past history of mental health problems.Isotretinoin may lead to permanent remission of the acne.Isotretinoin therapy may lower triglyceride levels.Women who fall pregnant on isotretinoin should be reassured that data from animal studies suggest that it is safe to take the drug up to the end of the first trimester.Answer: c
Acne, rosacea, and similar disorders
Published in Rashmi Sarkar, Anupam Das, Sumit Sethi, Concise Dermatology, 2021
Oral contraceptives containing a combination of progestin and oestrogen are used in women with resistant acne. The commonly used progestins are cyproterone acetate and drospirenone. They are not suitable for men because of the feminizing properties. Acne improvement is seen after some 6–8 weeks of use, but is not as effective as isotretinoin. It is associated with a number of minor side effects, essentially those associated with taking oral contraceptives.
Oral isotretinoin in the treatment of juvenile acne and psychiatric adverse effects – a systematic review
Published in Cutaneous and Ocular Toxicology, 2023
Isotretinoin is a lipophilic drug and therefore has the capacity of crossing the blood-brain barrier, so effects on the brain cannot be easily discarded [18]. Isotretinoin is a vitamin A derivative and can regulate gene expression as it can bind to retinoic acid receptors (RAR) directly or indirectly, via all-trans retinoic acid (ATRA), an isomer of isotretinoin [19]. RAR are present in the hippocampus and in the cerebral cortex, suggesting that altered hippocampal functioning may cause mood changes. Isotretinoin also increases apoptosis and thus decreases hippocampal neurogenesis, which can lead to depression [20,21]. Changes in serotoninergic activity are pointed out as another cause for the possible appearance of depression and behavioural alterations when treating acne with isotretinoin [22]. However, it is worth noting that even studies performed on mice are ambivalent and more research on this topic could be useful [23,24].
Ignoring the elephant in the room—overregulated isotretinoin and unregulated dietary supplements in the United States
Published in Baylor University Medical Center Proceedings, 2022
Dina H. Zamil, Praneet S. Paidisetty, Leonard K. Wang
It is quite concerning that isotretinoin, an already difficult drug to access, is becoming even more difficult to obtain given recent issues with iPledge. Thus, patients may turn to unvetted alternatives to address acne. The FDA has understandably focused its attention on isotretinoin due to potential birth defects, although vitamin A supplements continue to be unregulated despite evidence to suggest they can be equally dangerous for pregnant women.8,10 The iPledge REMS and other REMS programs must actively address workflow concerns and anticipate changes that threaten patient access to medication, even in the midst of changes. Adequate phone support and other fallback mechanisms should be put preemptively in place, especially in the setting of complicated planned changes. Increased FDA oversight of over-the-counter vitamin A supplements will also support reduced fetal exposure to high-dose vitamin A.11 Finally, healthcare professionals must continue to care for their patients within the existing regulatory environment. This includes remaining up-to-date on how to determine teratogenic risk of vitamin A–containing supplements and advocating for easier patient access to isotretinoin.8
Oral isotretinoin for acne: a complete overview
Published in Expert Opinion on Drug Safety, 2022
Alessia Villani, Francesca Nastro, Francesca Di Vico, Gabriella Fabbrocini, Maria Carmela Annunziata, Lucia Genco
The most serious side effect is teratogenicity. The overexpression of the proapoptotic transcriptional gene p53, which causes apoptosis in neural crest cells, is considered the main hypothesis [14,60]. A pregnancy test before beginning therapy and monthly thereafter must be required, as the use of safe contraceptive methods during and for 1 month after stopping the therapy. In a high percentage of cases (65–85%), the pregnancy proceeds without problems. The risk of spontaneous abortion is estimated between 10.9% and 20%, while the risk of birth defects, which includes craniofacial, thymus, and cardio anomalies, is 18–28% [61]. Isotretinoin treatment has also been associated with depression; their relationship still remains controversial. Depressive symptoms in patients treated with isotretinoin were first reported in 1983 [62]. The US FDA issued a warning in 1998 about the possibility for isotretinoin to cause depression, psychosis, suicidal ideation, and suicide. For patients receiving isotretinoin, the FDA recommends the use of signed informed consent forms and a printed patient medication guide [63–65].