Low-dose isotretinoin to be effective against resistant rosacea, study finds

Studies assessing LDI for rosacea, both randomized and non-randomized, were incorporated. Excluded studies included case reports, non-English research, and incomplete investigations. The Grading of Assessment, Recommendations, Development, and Evaluation scale was used to evaluate the quality of the study.

• Nearly 16 studies with a total of 1445 patients were included out of 435 studies. LDI had a significant impact on erythema and lesion count reduction.
• Isotretinoin reduced lesion count more than topical retinoids and topical antimicrobials (p = 0.03) with a moderate impact (SMD > 0.5).
• At 16 weeks following the end of LDI, the mean lesion count and erythema remained lowered by 70% and 47%, respectively.
• At 5.5 months after starting isotretinoin, the relapse rate was 35 percent, and 3 individuals (0.4%) noticed their rosacea get worse. Serious adverse effects were experienced by 3 patients (0.4%).

Overall, with acceptable tolerability and safety, LDI is a potentially useful therapy for moderate-to-severe or resistant rosacea, according to this combined systematic review and meta-analysis. Every study that used LDI for rosacea found that the condition improved with generally manageable, dose-dependent adverse effects.

Source:

King, A., Tan, M. G., Kirshen, C., & Tolkachjov, S. N. (2024). Low‐dose isotretinoin for the management of rosacea: A systematic review and meta‐analysis. In Journal of the European Academy of Dermatology and Venereology. Wiley. https://doi.org/10.1111/jdv.20315