JAMA Dermatol

Does isotretinoin improve acne in patients receiving masculinizing hormone therapy?

June 10, 2024

In this multicenter retrospective case series study involving transgender and gender-diverse individuals with acne who were receiving gender-affirming hormonal therapy, treatment with isotretinoin was associated with improvement in 97.0% and clearance in 63.6% of patients treated with a cumulative dose of 120 mg/kg or more. However, premature treatment discontinuation was common and associated with poorer outcomes.

• Among 55 included patients, mean age was 25.4 years; 7.3% were Asian, 3.6% were Black, 7.2% were Hispanic, 1.8% were multiracial, and 65.5% were White. Median isotretinoin course duration was 6 months, with a median cumulative dose of 132.7 mg/kg; cumulative dose was less than 90 mg/kg for 16 patients (29.1%) and less than 120 mg/kg for 22 patients (40.0%).
• Overall, isotretinoin was associated with improvement in 48 patients (87.3%) and clearance in 26 patients (47.3%). For the 33 patients treated with a cumulative dose of 120 mg/kg or more, these rates increased to 32 patients (97.0%) and 21 patients (63.6%), respectively. Among the 20 patients who achieved acne clearance and had any subsequent health care encounters, risk of recurrence was 20.0%.
• The most frequently reported adverse effects were dryness (80.0%), joint pain (14.5%), and eczema (9.1%). Reasons for premature treatment discontinuation included cost, pharmacy issues, adverse effects, logistical reasons (scheduling), and wound healing concerns for gender-affirming surgery.

Source:

Choe J, et al. (2024, May 29) JAMA Dermatol. Isotretinoin for Acne in Transgender and Gender-Diverse Individuals Receiving Masculinizing Hormone Therapy. https://pubmed.ncbi.nlm.nih.gov/38809569/