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Exploring the multifaceted side effects of isotretinoin: a deep dive into case reports and observational studies

Arch Dermatol Res. 2025 Feb 26;317(1):499. doi: 10.1007/s00403-025-04019-y.

ABSTRACT

This review addresses gaps in understanding isotretinoin’s side effects for acne vulgaris. While effective, the risks are often underestimated. It emphasizes careful patient selection and monitoring to optimize outcomes and minimize harm. By providing a comprehensive evaluation, the review aims to enhance patient safety and inform clinical decision-making. This review examined isotretinoin’s side effects through case reports and observational studies. A literature search on Google Scholar, PubMed, Scopus, and Web of Science covered publications from 2000 to 2024 using terms like “isotretinoin” and “side effects,” focusing on English-language studies. Inclusion criteria targeted studies detailing adverse effects across dermatological, musculoskeletal, psychiatric, ocular, gastrointestinal, endocrine, and renal areas. Data included population size, dosage, treatment duration, and side effects. No statistical analysis was performed. This review underscores a wide array of side effects associated with isotretinoin, ranging from common issues such as dry skin and cheilitis to more serious conditions including psychiatric disorders, musculoskeletal complications, and autoimmune diseases. Notably, rare side effects like psychosis and rhabdomyolysis have also been observed. The review emphasizes the necessity for meticulous patient selection, thorough risk assessment, and vigilant monitoring, especially for at-risk populations such as women of reproductive age. This review emphasizes the need for personalized evaluations and monitoring during isotretinoin treatment, particularly for high-risk groups like women of reproductive age. Healthcare providers must consider the risk-benefit ratio due to potential side effects. Regular check-ups and proactive management are crucial to optimize outcomes and minimize risks.

PMID:40009222 | DOI:10.1007/s00403-025-04019-y

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