The association between low serum Vitamin B12 levels and hyperpigmentation on patients who use Isotretinonin

Objective: Oral isotretinoin is the most effective agent in the treatment of acne vulgaris. The risk of pigmentation due to the systemic isotretinoin may be associated with  decrease in serum levels of  Vit B12. The study aims to contribute to the literature by defining the association between the increase in pigmentation caused by oral isotretinoin [O-ISO] use and low vitamin B12 level [vit-B12]. Methods: In our study we evaluated 144 patients, who have facial acnes at medium degree according to FDA Acne Score and take O-ISO treatment with the dose 0.5 mg/ kg/ day for six months. The relationship of the vitamin B12 levels of the patients at the admission and 6th month and the existence of pigmentation at 6th month, the skin type and the skin layer at which the pigmentation occurs, was evaluated.Association of vit-B12 level on admission and six months post drug use with the presence of pigmentation at six months, the type of skin and the skin layer in which pigmentation occurs were evaluated. Results: In the group with pigmentation, the mean vit-B12 level after six months of drug use was statistically lower than the mean vit-B12 level on admission [p <0.001]. In patients with no pigmentation, difference between the mean levels of Vit-B12 levels was not statistically significant [p = 0,255]. Conclusion: As a result, it was determined that the mean vit-B12 level decreased due to O-ISO use and the association of hyperpigmentation and low vit-B12 level was statistically significant. Vit -B12 monitoring and supplementation, if necessary, can help us prevent hyperpigmentation that may occur during the treatment.