Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science




Dr. Thomas Colletti


Acne, also known as acne vulgaris, is the most common type of skin disease and can affect people of all ages.1 It affects approximately 80% of the US population.1,2 It is a chronic skin condition that results from overactive sebaceous oil glands at the base of the hair follicle.3 Acne can be associated with non-inflamed open or closed comedones and/or inflammatory papules, pustules, cysts, nodules, and scarring.3 Acne is most commonly found on the face but can involve other areas of the skin such as the chest, back and shoulders.3Since 1982, isotretinoin has been routinely utilized for the treatment of moderate to severe acne.4,6 It remains the most effective treatment for moderate to severe acne despite much controversy over isotretinoin treatment and its possible association with depression and suicide.5 Isotretinoin has been well established in the efficacy of treating acne vulgaris. Treatment with isotretinoin has been associated with a controversial risk of depression and suicide.1A lack of evidence-based research to demonstrate the positive correlation of isotretinoin-related depression and suicide remains. Considering that isotretinoin is a vitamin A analog, there is plausible assumption of the correlation of mood disturbance.1Isotretinoin is a fat-soluble compound that crosses the blood brain barrier and affects areas of the brain that have been implicated in the development of depression. Chronically administering isotretinoin at a dose of 1-mg/kg has been shown to increase depression-related behavior in some studies involving mice and rats, but not consistently in other studies.1,6,7

Keywords:Isotretinoin, Accutane, Depression, Acne, Suicide


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