ABSTRACT
Systemic isotretinoin is the most efficient treatment option for the management of severe forms of acne vulgaris, especially nodulocystic acne. Apoptosis not only explains isotretinoin's mode of action in the treatment of acne and isotretinoin-responsive malignancies, but it is also related to isotretinoin's adverse drug effects including teratogenicity. Involution of sebaceous glands in acne patients treated with oral isotretinoin has been shown to be the major cause of sebum suppression. Long-term systemic treatment of female New Zealand rabbits with isotretinoin induces degenerative changes in the Meibomian gland acini, leading to a decrease in basaloid cells lining the acini walls. Isotretinoin treatment consistently induces mucocutaneous side effects by exhibiting dry skin with increased transepidermal water loss, often leading to retinoid dermatitis. Long-term use of isotretinoin in higher doses affects hair growth and is associated with increased hair loss and telogen effluvium. Isotretinoin normalizes the pattern of keratinization within the sebaceous follicle.
