Drug Use in Acne Vulgaris—Double-edged Sword of Oral Retinoids

Background: Acne vulgaris, a prevalent dermatological condition, affects adolescents and adults, leading to physical and psychological burdens. Isotretinoin, a potent oral retinoid, has revolutionised the treatment of severe acne but is associated with adverse effects, such as hepatotoxicity, hyperlipidaemia, and teratogenicity, necessitating cautious use. Objectives: This study evaluates isotretinoin’s therapeutic efficacy, safety profile, and impact on the quality of life (QoL) in patients with moderate to severe acne vulgaris. The primary objectives are to analyse drug utilisation patterns and assess QoL changes using the Cardiff Acne Disability Index (CADI). Methods: A prospective follow-up study was conducted on patients with moderate to severe acne attending a tertiary hospital. Data on demographics, prescriptions, lipid profiles, liver enzymes, and CADI scores were collected at baseline and after three months. Statistical analysis was performed using paired t -tests to assess changes. Results: Seventy patients participated, with a mean age of 20.63 ± 3.91 years. Isotretinoin (20 mg/day) was prescribed in 60% of cases. Significant increases in cholesterol (146.57–177.36 mg/dL, P < .05) and triglycerides (88.05–109.24 mg/dL, P < .05) were observed in the isotretinoin group, along with elevated liver enzymes. CADI scores improved significantly in this group (11.62–3.21, P < .001) compared to non-isotretinoin-treated patients. Conclusions: Isotretinoin effectively reduces acne severity and improves QoL but is associated with metabolic and hepatic side effects. Close monitoring of lipid and liver parameters is recommended. This study underscores isotretinoin’s efficacy while highlighting the need for safety vigilance in acne management.