Rational choice of combined therapy of acne: systemic isotretinoin and high-energy hardware technologies

Data on the analysis of efficacy and safety of combined use of systemic isotretinoin (SI) and hardware cosmetological methods in acne treatment are provided. It is known that SI is the drug of choice for the treatment of nodulocystic forms, resistant moderate and severe forms of acne. Despite the widespread application of SI, there are concerns about its various side effects, including changes in the wound healing process. It is traditionally recommended that any cosmetic procedures, including lasers, radio-frequency technologies, chemical peelings etc., should be postponed for at least 5—6 months after the end of SI intake. However, this conservative strategy has recently been challenged by several consensus expert opinions. Meta-analysis of articles on the combined use of SI and acne treatment by high-energy devices in PubMed, Embase, Web of Science databases has identified 650 publications from which a total of 16 studies were selected. General data indicate that the combination of SI (low doses) and high-energy procedures in acne treatment is safe and well tolerated. Thus, the use of SI in standard daily doses requires postponement of ablative laser procedures for 5—6 months after the end of therapy. SI in low doses combined with hardware cosmetological methods may be proposed as an alternative treatment method.