|WASHINGTON (March 1, 2019) — Acne is the most common skin condition in the U.S., affecting up to 50 million Americans annually, and it can have negative effects on patients’ mental health, including reduced self-confidence, anxiety and depression. Although the drug isotretinoin can lead to significant improvement for individuals with severe acne, mood disorders — including depression and suicidal ideation — have been reported in some patients taking the medication.
New research presented at the 2019 American Academy of Dermatology Annual Meeting in Washington, however, indicates that isotretinoin is not an independent risk factor for depression in adult acne patients.
“There has been mixed evidence and much debate around the impact of isotretinoin on mood change,” says board-certified dermatologist Bethanee Schlosser, MD, PhD, FAAD, an associate professor in the department of dermatology at the Northwestern University Feinberg School of Medicine in Chicago. “There’s also a lot of misinformation out there, particularly on social media, so we hope this large-scale study can shed some light on the issue.”
Dr. Schlosser and her colleagues evaluated medical records for more than 38,000 patients age 18-65 who were diagnosed with acne between January 2001 and December 2017. Forty-one of the 1,087 patients exposed to isotretinoin (3.77 percent) developed depression, compared to 1,775 of the 36,929 who were not exposed to isotretinoin (4.81 percent).
“These results showed no significant difference in frequency of depression between acne patients treated with isotretinoin and those who receive other types of therapy,” Dr. Schlosser says. “Further, we know the mere presence of acne can be associated with mood disorders, including depression, and isotretinoin can provide significant relief for patients whose acne is not responding to other treatments and causing severe psychosocial distress.”
No studies to date have established a causal relationship between isotretinoin and depression, Dr. Schlosser says, and her research indicates that the drug’s effect on mood is limited. She says more research in this area is necessary, however, and she encourages those with acne to see a board-certified dermatologist to discuss their treatment options and let their doctors know if they experience symptoms of depression.
“It is critical that patients maintain open and clear communication with their doctors,” Dr. Schlosser says. “A board-certified dermatologist can help you determine the best therapy for your acne while serving as a resource to your other health care providers.”
Frequency of depression in dermatologist-managed patients who have acne, isotretinoin-exposure vs no isotretinoin exposure: Pharmacovigilance analysis of a large Midwestern U.S. population from the RADAR (Research on Adverse Drug events And Reports) Program
Isotretinoin: Treatment for severe acne
About the AAD
Headquartered in Rosemont, Ill., the American Academy of Dermatology, founded in 1938, is the largest, most influential and most representative of all dermatologic associations. With a membership of more than 20,000 physicians worldwide, the AAD is committed to advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the AAD at (888) 462-DERM (3376) or aad.org. Follow the AAD on Facebook (American Academy of Dermatology), Twitter (@AADskin), Instagram (@AADskin1) and YouTube (AcademyofDermatology).