Skin hydration and sebum levels in acne patients after thetreatment with isotretinoin

Background and aim: Acne vulgaris is a chronic disease is of the pilosebasous unit characterized by comedones, papules, pustules and nodules in the face, especially seborrheic regions. Isotretinoin is a retinoic acid derivative and affects all four factors involved in the pathogenesis of acne. In some patients after isotretinoin treatment, scars may be treated with medical-cosmetic procedures. Since it may take time for skin to return to its natural physical parameters after the use of isotretinoin and these properties may affect subsequent skin care, it will be useful and guiding to know the skin properties after treatment. In our study, it was planned to measure skin sebum and moisture levels in the acne patients during the first 15 months after the isotretinoin treatment compared to untreated acne patients and healthy control group. Material and Method: The study included 74 patients who were admitted to the outpatient clinic of dermatology for acne and treated with isotretinonin, at Aydın Adnan Menderes University Hospital between 1.1.2018-1.4.2019. The control groups consisted of 22 age and sex matched acne patients who had not used any topical or systemic acne treatment for the last 1 month and 21 healthy controls without acne. Demographic characteristics, duration of isotretinoin use, dose, last date of isotretinoin use, participants view about their own skin hydration and oiliness on the face on a 4 point scale ((from 1: too low to 4: too high) were recorded. The number of acne lesions (comedones, papules, pustules, nodules) were recorded and acne severity index (ASI) was calculated. Then, skin sebum and moisture levels in glabella, mentum, right and left malar regions were measured with Multi-Probe-Adapter (MPA)-5. Results: Patients who received isotretinoin in the past were divided into 5 groups as 0-3 months, 4-6 months, 7-9 months, 10-12 months, 13-15 months after the end of treatment. There was no statistically significant difference between the groups in terms of age, sex, daily dose / kg (p = 0.368) and cumulative dose / kg (p = 0.165) of isotretinoin. ASI (acne severity index) median value was 21 in the acne group and were 0, 0, 0, 3, 0 in the post-treatment period groups respectively. Sebum level was significantly higher in patients with acne than healthy controls. After isotretinoin treatment, sebum levels were significantly lower than those of acne patients during the first 15 months and at similar levels compared with the healthy controls. In terms of moisture level, no significant difference was found between the patients with acne, the patients who passed the 0-15 months after the discontinuation of isotretinoin use and the healthy control group. In terms of the personal view of skin oiliness and moisture on the face, acne patients view of "oilines" was significantly more than the views of healthy controls, 0-3 months and 10-15 months after isotretinoin treatment. There was no significant difference between the groups in terms of personal view of moisture on their face. Conclusion: In our study, skin sebum and moisture levels were found to be similar to healthy subjects in the acne patients up to 15 months after the use of isotretinoin. Therefore there may be no need to make different recommendations to patients in this period than the healthy people in terms of skin care, cosmetic or surgical procedures.