Mechanism of Action of Isotretinoin
October 2019
in “
CRC Press eBooks
”
isotretinoin severe acne vulgaris nodulocystic acne apoptosis teratogenicity sebaceous gland involution sebum production Meibomian gland acini basaloid cells mucocutaneous side effects dry skin retinoid dermatitis hair growth hair loss telogen effluvium keratinization patterns sebaceous follicles Accutane severe acne cystic acne cell death birth defects oil gland shrinkage oil production eye gland acini skin side effects skin inflammation hair shedding hair thinning hair loss phase skin cell patterns oil gland follicles
TLDR Isotretinoin effectively treats severe acne but can cause significant side effects like dry skin and hair loss.
Systemic isotretinoin was the most effective treatment for severe acne vulgaris, particularly nodulocystic acne, by inducing apoptosis, which also explained its adverse effects like teratogenicity. It caused sebaceous gland involution, reducing sebum production. In female New Zealand rabbits, long-term isotretinoin use led to degenerative changes in Meibomian gland acini and decreased basaloid cells. It consistently caused mucocutaneous side effects, such as dry skin and retinoid dermatitis, and long-term high doses affected hair growth, leading to increased hair loss and telogen effluvium. Isotretinoin also normalized keratinization patterns in sebaceous follicles.
