Isotretinoin and Mood Disorders in Patients With Acne Vulgaris - Literature Review

Introduction and Aim: Acne vulgaris is among the most prevalent dermatological conditions affecting adolescents and young adults. Visible acne lesions may considerably reduce quality of life, negatively influence self-esteem, and impair social functioning. Oral isotretinoin is widely considered the treatment of choice for severe and therapy-resistant acne. Nevertheless, concerns have long been raised regarding its potential association with psychiatric symptoms, particularly mood disturbances, depression, and suicidal behaviour. The purpose of this review is to summarise current clinical evidence concerning the relationship between isotretinoin therapy and mood disorders in patients with acne vulgaris, with particular attention to factors that may explain the observed clinical outcomes. Material and Methods: A narrative literature review was performed using advanced searches in the PubMed database. The analysis included English-language publications from the last five years, such as clinical and observational studies, systematic reviews, and meta-analyses focusing on depressive symptoms, psychiatric adverse events, and quality-of-life changes among patients receiving isotretinoin for acne vulgaris. Conclusions: The currently available evidence does not conclusively demonstrate a clinically meaningful increase in depression risk in the general population of patients treated with isotretinoin. However, in some individuals, specific vulnerability factors may increase susceptibility to mood disturbances, supporting the need for careful psychological monitoring during therapy. In many patients, improvement in acne severity is accompanied by better well-being and enhanced quality of life. Further research is required to clarify the neurobiological mechanisms underlying isotretinoin activity and to identify patients at greatest risk of psychiatric complications. These findings emphasize the importance of individualized risk–benefit assessment and close cooperation between dermatologists, general practitioners, and mental health specialists.