Weight Change With Isotretinoin Treatment for Acne Vulgaris Not Statistically Significant

Oral isotretinoin used for the treatment of acne vulgaris did not yield statistically significant changes in weight gain/body mass index (BMI) or metabolic syndrome markers among patients, according to a study published in the Journal of Cosmetic Dermatology.¹

Researchers noted that when administered at the correct dosage, oral isotretinoin yields minimal complications.

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Background and Methods

Previous research is indicative of the influence of retinoids on leptin secretion from fat cells. Increased leptin levels are commonly associated with obesity and the onset of metabolic syndrome.²

Researchers Bazargan sought to assess changes, if any, in patients' BMI and metabolic syndrome markers prior to versus after treatment with oral isotretinoin.

The prospective investigation involved patients undergoing treatment with oral isotretinoin in 2019 and 2020. Participants were selected through convenience sampling, with inclusion criteria requiring a diagnosis of severe acne vulgaris, completion of a 3-month treatment, and active participation in follow-up visits. Researchers conducted measurements and metabolic tests before and after treatment to assess changes in waist circumference and weight, with data collected and analyzed to identify any correlation with metabolic syndrome based on specific criteria.

Findings

The study included a total of 62 Iranian patients with severe acne vulgaris, divided between those taking 20 mg daily and those taking it every other day. Among the participants, who had an average age of 21.27 years, 55 were women, and 7 were men.

Prior to participation in the study, 6.45% of patients were diagnosed with metabolic syndrome. Common comorbidities among participants included androgenetic alopecia, polycystic ovary syndrome, hypertension, and asthma.

Initial measurements demonstrated baseline levels of low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, and blood glucose were within standard ranges, with the recorded waist circumference averaging 77.33 cm.

Following 3 months of treatment with oral isotretinoin, researchers reported slightly elevated levels of LDL, small variation in HDL and triglyceride levels, and a minimal increased in waist circumference.

However, these changes were not deemed statistically significant, nor were any changes in BMI, metabolic syndrome prevalence, or other metabolic parameters when comparing pre-treatment and post-treatment data. Furthermore, researchers reported a constant distribution of metabolic syndrome frequency at all points of the study period, noting that any differences observed between patients entering the study with versus without a metabolic syndrome diagnosis were not statistically significant in nature.

Conclusions

Limitations of the study, as noted by its authors, include a limited sample size of patients and close-together follow-up periods.

"Isotretinoin, as an effective treatment option for acne in standard doses, does not have metabolic side effects such as weight changes, BMI, and other factors related to metabolic diseases like BS levels, triglyceride levels, LDL levels, HDL levels, and so on," according to Bazargan et al.

Moving forward, they recommended studies of a larger nature that include lengthier follow-up periods in order to validate and support these findings.

References

1. Bazargan AS, Jafarzadeh A, Danandeh F, Salehi S. Investigating metabolic syndrome markers and body mass index changes in patients with acne vulgaris treated with isotretinoin: a prospective study. J Cosmet Dermatol. August 14, 2024. https://doi.org/10.1111/jocd.16533
2. Patel SB, Reams GP, Spear RM, Freeman RH, Villarreal D. Leptin: linking obesity, the metabolic syndrome, and cardiovascular disease. Curr Hypertens Rep. 2008; 10(2): 131-137.