USA: Acne Treatment Study

A recent study in the Journal of Drugs in Dermatology finds that acne patients treated with isotretinoin experience less psychological distress and depressive symptoms compared to those treated with oral antibiotics.

Acne vulgaris is a common skin disease that affects more than 10 million people in India per year. Acne negatively impacts self-confidence and body image due to its predilection for the face, which can lead to depression and psychological distress. Oral antibiotics are among the most commonly used systemic acne treatments. The most commonly used oral antibiotics are the tetracyclines, which include minocycline, doxycycline, and tetracycline. However, their use may be limited by potential side effects.

Not much is known about the different effects of systemic anti-acne treatments on mental health. Joshua Hekmatjah, from the Homer Stryker MD School of Medicine, Kalamazoo, MI, and colleagues aimed to determine if acne patients treated with isotretinoin versus oral antibiotics (doxycycline, minocycline, or tetracycline) have different mental health outcomes.

For the population study, the researchers utilized the 2004-2017 Medical Expenditure Panel Survey. Using the Patient Health Questionnaire 2 (PHQ-2), depressive symptoms were assessed, and the Kessler 6-Item Psychological Distress Scale (K6) was used to measure psychological distress. Acne patients completed both the PHQ-2 and K6 during treatment with isotretinoin or oral antibiotics. Lower scores on both measures indicate better mental health outcomes.

Key Findings of the Study

• After adjusting for socio-demographic characteristics, patients on isotretinoin had fewer depressive symptoms than patients on oral antibiotics, as measured by mean PHQ-2 scores (isotretinoin 0.280 vs oral antibiotics 0.656).
• The adjusted comparison also showed patients on isotretinoin had less psychological distress than patients on oral antibiotics, as measured by K6 scores (isotretinoin 2.494 vs oral antibiotics 3.433).

"Acne patients on isotretinoin experienced less depressive symptoms and psychological distress as compared to oral antibiotics," wrote the authors.

"In addition to assessing the safety profile of systemic treatment options, dermatologists must also take into account the physical and mental health burden of disease when treating patients with moderate to severe acne," they concluded.

The study titled, "Depression and Distress in Acne Patients on Isotretinoin vs Oral Antibiotics," is published in the Journal of Drugs in Dermatology.

DOI: https://jddonline.com/articles/dermatology/S1545961621P0172X