Consensus recommendations on isotretinoin and timing of skin procedures

A new article published by JAMA Dermatology reports on a panel of national experts that was convened and a review of the medical literature that was done to provide evidence-based recommendations regarding the safety of skin procedures performed either concurrently with, or immediately after, treatment with the acne medication isotretinoin.

For decades, it has been widely taught that isotretinoin causes abnormal scarring or delayed wound healing, although this notion stems from three case series published in the mid-1980s describing only a handful of patients, according to the article.

New consensus recommendations are presented in the review article by corresponding author Leah K. Spring, D.O., of the Naval Hospital Camp Lejeune in North Carolina, and Andrew C. Krakowski, M.D., of DermOne, LLC., West Conshohocken, Pa., and coauthors. The medical literature review included 32 relevant articles reporting on 1,485 procedures.

The article reports "insufficient evidence" to support delaying manual dermabrasion, superficial chemical peels, skin surgery, laser hair removal, and fractional ablative and nonablative laser procedures for patients who are currently taking or who have recently completed isotretinoin therapy. However, mechanical dermabrasion and fully ablative laser procedures are not currently recommended.

"With the information presented in this article, physicians may have an evidence-based discussion with patients regarding the known risk of cutaneous surgical procedures in the setting of systemic isotretinoin treatment. For some patients and some conditions, an informed decision may lead to earlier and potentially more effective interventions," the article concludes.