What do we know about isotretinoin?

Abstract

Acne treatment has been revolutionized since 1982 when isotretinoin was approved for the first time for the condition. Isotretinoin (13-cis-retinoic acid) is still the most effective treatment for acne. Systemic retinoid (a derivative of vitamin A) is the only drug acting on all links of the pathogenesis of this disease. Isotretinoin is believed to improve the condition of the skin in acne by reducing sebum production by the sebaceous glands, normalizing follicular keratinization and suppressing the growth of Actinobacterium acnes (Propionibacteriaceae family) by changing the follicular environment and reducing inflammation. Despite being widely prescribed by doctors for almost forty years, there is still a lot of uncertainty about how best to prescribe this drug, how long the remission lasts, and what side effects there may be. Isotretinoin has been proven to be highly effective and well tolerated, but like any medicine, it also has certain side effects, but it should be understood that they dose-dependent and reversible. We provide up-to-date information on the possible side effects of isotretinoin and discuss ways to prevent and treat these side effects.