Objectives: Revision of the isotretinoin farmacocinetic and side effects as well as some of the most common concerns about their use in acne treatment.
Introduction: There are a before and after isotretinoin use in the history of acne treatment in terms of efficacy, results and scar sequela. Noneless, the side effects of the initial dose of more than 0,5 mg /Kg/day and the teratogenicity of the drug originated a plethora of myths, misjudgments and fears in both doctors and patients.
Materials / method: we revue the cientifical data, clinical cases and papers in PubMed and other medical sorces about: growing problems in children, suicidal and depression in teenagers, fertility and teratogenicity, doses and how long treated, inflamation rebound, interactions with other drugs and vitamin A, laboratory abnormalities and surveillance.
Results: Medium to low doses, simple lab controlling and, most of all, clinical supervision in consultation could make the difference in terms of results, side effects and patients compliance.
Conclusion: Oral isotretinoin is a drug with more than 30 years in the market and represents a milestone in acne history. Their use is very useful in moderate cases and a must in the severe ones. Besides teratogenicity, the majority of side effects are dose dependent and well minimised and controlled by doctors experienced in their use. Taking time with the patients to explain how to use it is crucial.
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