Isotretinoin 0.05% gel

BackgroundRhinoplasty outcomes in patients with thick nasal skin may be challenging due to the sebaceous nature of the skin, which can compromise tip definition and delay resolution of postoperative edema. Perioperative adjunct using isotretinoin is suggested as a well-established treatment for acne and sebaceous hyperactivity.MethodsWe conducted this systematic review in accordance with PRISMA guidelines. Literature searches were performed in PubMed, Scopus, Web of Science, and Embase databases for studies published up to March 2025. Search strategies incorporated combinations of keywords relating to "rhinoplasty," "isotretinoin," "nasal skin," and "wound healing." Eligible studies included randomized controlled trials (RCTs), cohort and retrospective studies, with human participants undergoing rhinoplasty with or without systemic or topical isotretinoin, reporting on outcomes such as skin thickness, edema, patient satisfaction, wound healing, and complications. Risk of bias and quality assessment were assessed with the Joanna Briggs Institute (JBI) critical appraisal tools.ResultsThis systematic review included seven eligible studies-all with human participants-three RCTs, three retrospective cohort studies, and one prospective cohort study. We found that isotretinoin improved nasal tip definition, decreased postoperative edema, and improved patient satisfaction. Specific studies reported a marked reduction in sebaceous gland activity, and shaved-off nasal skin thickness was considered responsible for the more refined aesthetic outcome. No significant adverse effects other than mild mucosal dryness and transient cheilitis were observed; it seemed to accelerate wound healing. However, causality within isotretinoin use could not be established in some studies, and some needed revision surgery.ConclusionIsotretinoin administration, particularly when individualized by patient profile, appears to significantly improve both aesthetic and wound-healing outcomes in rhinoplasty patients with thick nasal skin and displays a favorable safety profile under close monitoring. Further large-scale RCTs are required to optimize dosage and perioperative protocols.

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BackgroundIsotretinoin is an effective therapy for acne vulgaris, but its impact on thyroid function remains uncertain, with existing studies reporting inconsistent biochemical changes.ObjectiveTo assess the effects of oral isotretinoin on serum thyroid function parameters and thyroid antibody levels in patients with acne vulgaris.MethodsA systematic review and meta-analysis of observational studies was conducted according to PRISMA guidelines and prospectively registered (INPLASY202560049). PubMed, Scopus, Embase, and Web of Science were searched from January 1980 to September 2025. Studies reporting serum thyroid parameters before and during isotretinoin therapy were included. Random-effects meta-analyses were performed for parameters reported in more than three studies. Heterogeneity was assessed using the I2 statistic, and risk of bias using NIH tools.ResultsFifteen studies were included. Meta-analysis showed a small statistically significant increase in thyroid-stimulating hormone after isotretinoin treatment (MD = 0.03, 95% CI 0.02‒0.05, p 2 = 85%) and triiodothyronine (I2 = 86%), and moderate for thyroxine (I2 = 60%). Evidence regarding thyroid antibodies was limited and inconsistent.Study limitationsIncluded studies were observational, predominantly single-centre, and heterogeneous in dosing, duration, and laboratory assessments.ConclusionsIsotretinoin is associated with statistically significant alterations in serum thyroid function parameters, though the clinical significance of these changes remains uncertain.

Abstract licence: CC BY