Acne Treatment: combine isotretinoin with an antihistamine to enhance results and reduce side-effects
- Isotretinoin remains the gold standard in the treatment of Acne Vulgaris especially since tolerable doses nowadays focus on low doses. However, even with this, patients can have difficulty tolerating them because of the occurrence of side effects such as xerosis of the skin and mucous membranes. Also, even here, isotretinoin can have adverse effect on liver function and lipid metabolism.
- To combat this the authors have found a study advocating the beneficial affects of antihistamines. The authors did a study in forty patients* 20 with isotretinoin and 20 with additional desloratadine (Aerius) (an selective anti-H1 receptor antagonist).
- Results show that at 20 weeks, patients also taking the antihistamine had a significant decrease in acne lesion counts, sebum and erythema.
- Also the occurrence of flares was significantly reduced occurring in only one treated with the combination (vs 6 in the isotretinoin only treated group). Moderate-to-servere acne flares were absent in the « dual group » whereas in the isotretinoin-only treated group, 3 people were affected.
Comment：with no conflicts of interest disclosed, the beneficial effect of anthistamines (here desloratine) seem too be warranted in the treatment with isotretiboin. The limitations pertains to the lack of long term follow-up.
Dr Christophe Hsu – dermatologist. Geneva, Switzerland
Article selection: Prof Dr Jean-Hilaire Saurat – dermatologist. Geneva, Switzerland
Source of information: Effect of antihistamine as an adjuvant treatment of isotretinoin in acne: a randomized, controlled comparative study. Lee HE, Chang IK, Lee Y, Kim CD, Seo YJ, Lee JH, Im M.nJ Eur Acad Dermatol Venereol. 2014 Feb 21. doi: 10.1111/jdv.12403.