Safety Considerations and Monitoring in Patients Treated with Systemic Medications for Acne

The 2016 document reviews the side effects and monitoring guidelines for systemic acne treatments such as tetracyclines, spironolactone, and isotretinoin. It notes that minocycline is associated with autoimmunity and hypersensitivity, while doxycycline is safer with fewer serious adverse effects. Routine serum potassium monitoring for healthy young women on spironolactone may be unnecessary. The document stresses the importance of informing patients about isotretinoin's ocular adverse effects and suggests that low-dose intermittent regimens can reduce side effects like mucocutaneous issues, which are generally reversible. It also discusses the controversial psychiatric effects of isotretinoin, its teratogenic risks, and the need for liver function and lipid monitoring. The frequency of laboratory monitoring has decreased, and it may not be necessary for all patients on isotretinoin. The document underscores the importance of healthcare providers being knowledgeable about side effects and patient education for effective monitoring.