Facial hypertrichosis in the course of isotretinoin treatment: four-year retrospective observation

Abstract

Background: isotretinoin is a synthetic retinoid used in the treatment of acne. There are limited and inconsistent data about the effects of isotretinoin on hormones and hair growth. Aim: to investigate a probable connection, a single center four-year retrospective data of female acne patients who were treated with oral isotretinoin, and developed facial hypertrichosis was reported. Methods: in the years 2019-2023, 327 female patients between 16-33 years of age (Mean ± Standard Deviation: 23.4 ± 4.7) were treated with 0.5-0.8 mg/kg/day isotretinoin, approximately for 6 months (6.2 ± 0.8). The patients who developed facial hypertrichosis were additionally analysed for dehydroepiandrosterone sulfate, prolactin and thyroid stimulating hormone values. Results: thirty-one patients (9.5%) in all ages (22.9 ± 4.3) declared excessive hair growth on cheeks and/or chin during treatment. All declarations were between the 2nd and 4th months (2.6 ± 0.8). The mean values of the analysed hormones were in normal ranges. Twenty seven of the thirty one patients (87%) stated that the excessive hair growth terminated completely at the end of 4th month (3.1 ± 0.7) after the cessation of the treatment, and the others declared it diminished to a great extent. Conclusions: mainly due to normal mean values of the analysed hormones, it is unlikely to consider them as the cause of hypertrichosis. Prospective studies with larger sample sizes and comprehensive hormonal profiling are essential to better understand this side effect.