Efficacy and Safety of Topical Versus Systemic Isotretinoin for Acne Vulgaris Treatment: A Systematic Review

Abstract

Introduction: Oral Isotretinoin has been used for years to successfully treat and manage severe acne. Topical isotretinoin has also been used to manage acne. However there exist very few studies that assess the safety and efficacy of topical isotretinoin. The aim of this systematic review is to evaluate available literature that report on the safety and efficacy of topical isotretinoin particularly in the management of acne. Methods: A systematic review of existing literature. Online searches were conducted on various databases including PubMed, PubMed Central, Embase, CINAHL, the Cochrane Central Register of Controlled Trials, Web of Knowledge, PsycINFO and Scopus. Studies were assessed for eligibility using the specified inclusion and exclusion criteria. The researchers independently reviewed the abstracts and differences were settled by a consensus. Relevant data was extracted from eligible studies, including author and year of publication, study type, research design, number of participants, study aim and main findings from each study. Results: Out of the 274 studies identified through search of databases and registers, 11 studies met the criteria for inclusion in the systematic review. A total of 1129 patients were included in the systematic review. The studies were from different geographical regions and countries. The studies found that topical isotretinoin was used in the management of acne and other dermatological conditions. Conclusion: Topical isotretinoin is comparatively effective for the treatment of acne vulgaris of various degrees of severity, with minimal side effects. Further research is needed to understand its long-term safety, especially for high-risk populations. With appropriate monitoring, primary care clinicians should consider it for moderate to severe acne, especially in high-risk populations for whom the use of oral isotretinoin could be problematic or is contraindicated.