Dose Reduction May Lower Hair Loss Frequency, Allow for Longer Use of Isotretinoin for Acne

Whereas hair loss is a documented aspect impact of isotretinoin for sufferers taking the therapy for acne, there are restricted knowledge pointing to the frequency of hair loss based mostly on dosage. Nevertheless, in a brand new study, researchers discovered that the frequency of hair loss ranges between 3%-6% based mostly on the dose.

On the upper finish, frequency of hair loss is corresponding to the frequency of different unwanted effects, reminiscent of dry eyes, which are generally mentioned with sufferers. Based mostly on their findings, the researchers advised suppliers focus on the aspect impact with sufferers previous to initiating isotretinoin and monitor the aspect impact throughout therapy.

“Hair loss within the type of telogen effluvium is a reported aspect impact of isotretinoin that may result in therapy discontinuation. Though its mechanisms are unclear, retinoids are thought to arrest the onset of the anagen part of the hair cycle and impair the anchoring of hair throughout the telogen part, finally growing hair shedding,” described the researchers, who added that “the precise frequency and related dose dependency of hair loss with using isotretinoin stay unclear.”

Information from 22 research had been collected on reported hair loss with isotretinoin therapy, displaying a hair loss frequency of three.2% for sufferers receiving <0.5 mg/kg/day and a frequency of 5.7% for sufferers receiving ≥0.5 mg/kg/day.

With present therapy suggestions suggesting that sufferers be away from pimples for 1-2 months earlier than discontinuing isotretinoin to scale back the chance of recurrence, the researchers beneficial prescribing a decrease dose for an extended interval to realize the benchmark earlier than discontinuing. Whereas stressing the significance of dose discount for hair loss frequency, the researchers additionally included intermittent dosing as a attainable different for therapy, significantly in sufferers with mild-to-moderate pimples.

Simply 1 small examine supplied knowledge on time to hair loss onset, which indicated a median time to onset of 4 weeks. The researchers famous that it’s not clear whether or not the length or dose of isotretinoin impacts the time to onset of hair loss.

There have been 2 research that explored the reversibility of hair loss with isotretinoin therapy, one in all which detailed hair loss in 150 sufferers who skilled persistent hair loss after stopping therapy. Nevertheless, the researchers emphasised that there aren’t any knowledge to assist the discovering and each the timeframe and variety of affected sufferers weren’t clear. The second examine was retrospective and advised that hair loss was reversible in 30 sufferers receiving a excessive dose of therapy.

“The reversibility and extent of hair regrowth are vital to contemplate as a result of sufferers might view everlasting hair thinning as a barrier to remedy,” wrote the researchers. “Though the product monographs of isotretinoin formulations (Clarus, Epuris, and Accutane) warn that hair loss might persist after therapy is accomplished, there isn’t any definitive proof to assist this prognosis.”

Reference:

Lytvyn Y, McDonald Ok, Mufti A, Beecker J. Evaluating the frequency of isotretinoin-induced hair loss at <0.5-mg/kg/d versus ≥0.5-mg/kg/d dosing in pimples sufferers: a scientific evaluation. J Am Acad Dermatol. Revealed on-line February 10, 2022. doi:10.1016/j.jdin.2022.01.002