Beyond Clinical Efficacy: A Literature Review on the Safety Challenges of Isotretinoin Therapy

This literature review examines the safety challenges of isotretinoin therapy for acne vulgaris, emphasizing its efficacy in addressing acne's pathogenic mechanisms and achieving high clearance and long-term remissions. The most common adverse effect is mucocutaneous dryness, which is manageable with proper skincare. Other concerns include mild, reversible dyslipidemia and liver enzyme elevations, with teratogenicity being the most serious risk, necessitating strict pregnancy-prevention programs. No increased incidence of depression or inflammatory bowel disease has been confirmed, but clinical monitoring is crucial. Musculoskeletal and ophthalmologic effects are generally mild and dose-dependent. The review concludes that structured risk management, regular monitoring, and using the lowest effective dose can ensure safe and effective acne control with isotretinoin.