Oral Isotretinoin and Photoaging.

INTRODUCTION: Over the past 20 years, evidence has emerged indicating oral isotretinoin could be considered a potential treatment for photoaged skin. In this review we provide a succinct overview of the available evidence and provide commentary on the current and future directions for utilizing oral isotretinoin as a potential treatment for photoaging. METHODS: We conducted a review to examine oral isotretinoin to improve photoaging. We prepared a review protocol and searched the PubMed and Cochrane databases for relevant literature published between January 1982 and April 2020. Using a defined keyword search, a total of 23 papers were initially identified by the main author. Two authors independently reviewed each of the 23 articles and 6 articles were deemed relevant to this study. RESULTS: Of the 6 studies included in this review, 3 were randomized clinical trials, 1 was a non-randomized clinical trial and 2 were prospective cohort studies. All studies were conducted between 2000 and 2015. Across all 6 studies, 251 patients were recruited, with a mean of 42 patients per study. Four studies were in favor of isotretinoin to improve photoaged skin, 1 study showed no benefit, and 1 study showed no benefit when compared to topical tretinoin treatment. Of the studies available, many were hampered by methodological challenges. CONCLUSION: Oral isotretinoin may be useful for treating photoaging but there is currently insufficient evidence to support its use. In comparison to other established anti-photoaging treatments, it is not clear if the potential benefits of oral isotretinoin outweigh the potential risks.