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Cited by 148Dermatologic Treatments and ResearchAcne and Rosacea Treatments and EffectsNonmelanoma Skin Cancer Studies

Isotretinoin and Timing of Procedural Interventions

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Spring, Leah K., Krakowski, Andrew C., Alam, Murad, Bhatia, Ashish, Brauer, Jeremy, Cohen, Joel, Del Rosso, James Q., Diaz, Lucia +21 more·2017·JAMA Dermatology
DOI 10.1001/jamadermatol.2017.2077
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Abstract

Importance: The notion that systemic isotretinoin taken within 6 to 12 months of cutaneous surgery contributes to abnormal scarring or delayed wound healing is widely taught and practiced; however, it is based on 3 small case series from the mid-1980s. Objective: To evaluate the body of literature to provide evidence-based recommendations regarding the safety of procedural interventions performed either concurrently with, or immediately following the cessation of systemic isotretinoin therapy. Evidence Review: A panel of national experts in pediatric dermatology, procedural/cosmetic dermatology, plastic surgery, scars, wound healing, acne, and isotretinoin was convened. A systematic PubMed review of English-language articles published from 1982 to 2017 was performed using the following search terms: isotretinoin, 13-cis-retinoic acid, Accutane, retinoids, acitretin, surgery, surgical, laser, ablative laser, nonablative laser, laser hair removal, chemical peel, dermabrasion, wound healing, safety, scarring, hypertrophic scar, and keloid. Evidence was graded, and expert consensus was obtained. Findings: Thirty-two relevant publications reported 1485 procedures. There was insufficient evidence to support delaying manual dermabrasion, superficial chemical peels, cutaneous surgery, laser hair removal, and fractional ablative and nonablative laser procedures for patients currently receiving or having recently completed isotretinoin therapy. Based on the available literature, mechanical dermabrasion and fully ablative laser are not recommended in the setting of systemic isotretinoin treatment. Conclusions and Relevance: Physicians and patients may have an evidence-based discussion regarding the known risk of cutaneous surgical procedures in the setting of systemic isotretinoin therapy. For some patients and some conditions, an informed decision may lead to earlier and potentially more effective interventions.

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Cited works that were retracted

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  • Cites a retracted work: 10.1186/s40001-014-0060-x

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    The cited work was retracted on 2014-11-07 (notice 10.1186/s40001-014-0060-x), before this paper was published (2017-08-01). Its authors could have known.

    Cited work 10.1186/s40001-014-0060-x · retracted 2014-11-07 · notice 10.1186/s40001-014-0060-x · this paper published 2017-08-01

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Authors
Spring, L. K., Krakowski, A. C., Alam, M., Bhatia, A., Brauer, J., Cohen, J., Del Rosso, J. Q., Diaz, L., Dover, J., Eichenfield, L. F., Gurtner, G. C., Hanke, C. W., Jahnke, M. N., Kelly, K. M., Khetarpal, S., Kinney, M. A., Levy, M. L., Leyden, J., Longaker, M. T., Munavalli, G. S., Ozog, D. M., Prather, H., Shumaker, P. R., Tanzi, E., Torres, A., Velez, M. W., Waldman, A. B., Yan, A. C., & Zaenglein, A. L.
Affiliations
  • United States Department of the Navy (US)
  • DermOne, LLC, West Conshohocken, Pennsylvania
  • Northwestern University (US)
  • Laser and Skin Surgery Center of New York (US)
  • AboutSkin Dermatology, Lone Tree, Colorado8DermSurgery, Lone Tree, Colorado
  • Dermatology Department, Touro University Nevada College of Health and Human Services, Henderson
  • Dell Children's Medical Center of Central Texas (US)
  • SkinCare Physicians, Chestnut Hill, Massachusetts
  • University of California San Diego (US)
  • Stanford University (US)
  • Laser and Skin Surgery Center of Indiana (US)
  • Henry Ford Health (US)
  • University of California, Irvine (US)
  • Wilmington Health, PLLC, Wilmington, North Carolina
  • University of Pennsylvania (US)
  • Institute for Stem Cell Biology and Regenerative Medicine
  • Dermatology, Laser & Vein Specialists of the Carolinas (US)
  • Henry Ford Hospital (US)
  • Westlake Dermatology, Austin, Texas
  • Naval Medical Center San Diego (US)
  • George Washington University (US)
  • Loma Linda University Medical Center (US)
  • Brigham and Women's Hospital (US)
  • Children's Hospital of Philadelphia (US)
  • Pennsylvania State University (US)
ORCID
Venue
JAMA Dermatology
Publisher
American Medical Association (AMA)
Published
2017-08-01
Volume
153
Issue
8
Pages
802
ISSN
2168-6068 (ISSN-L)
DOI
10.1001/jamadermatol.2017.2077
OpenAlex
W2731786563
Semantic Scholar
7798ab18bdd7d80ae6ada66834fa590ecc371f32
Cited by
148
References
32
Citations by year
2026: 22 · 2025: 13 · 2024: 15 · 2023: 19 · 2022: 13 · 2021: 17 · 2020: 16 · 2019: 15 · 2018: 12 · 2017: 5
FWCI
13.21
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JAMA Dermatology (publishedVersion)
  • PubMed (publishedVersion)
  • eScholarship (California Digital Library) (submittedVersion, cc-by)
  • Touro Scholar (Touro College) (submittedVersion)
Topics
  • Health Sciences › Medicine › Dermatology › Dermatologic Treatments and Research
  • Health Sciences › Medicine › Dermatology › Acne and Rosacea Treatments and Effects
  • Health Sciences › Medicine › Epidemiology › Nonmelanoma Skin Cancer Studies
Keywords
isotretinoin, acitretin, retinoids, wound healing, scar formation, hypertrophic scars, keloids, dermabrasion, chemical peels, laser hair removal, ablative lasers, non-ablative laser, acne, procedural safety
MeSH terms
Cicatrix, Dermatologic Agents, Humans, Skin, Time Factors, Wound Healing, Isotretinoin, Dermatologic Surgical Procedures

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