Impact of Isotretinoin Therapy on Thyroid Hormone Levels in Patients with Acne Vulgaris: A Systematic Review and Meta-Analysis.
4 affiliations
- 1College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
- 2College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia.
- 3College of Medicine, King Saud University, Riyadh, Saudi Arabia.
- 4Department of Pediatric Dermatology, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
Abstract
Introduction
Systemic isotretinoin is extensively used to treat moderate-to-severe acne vulgaris and may have systemic endocrine effects through the hypothalamic-pituitary-thyroid axis.Objectives
To investigate the changes in thyroid hormone levels after commencement of systemic isotretinoin among patients with acne vulgaris.Methods
A PubMed, ScienceDirect, Scopus, and Cochrane Library search was performed. Pooled analysis was conducted utilizing Review Manager (RevMan 5.4.1).Results
A total of 447 patients from eight observational studies were included. After three and four months, no increase in TSH levels was observed following isotretinoin treatment with a standardized mean difference (SMD) of 0.09 (95% CI: -0.27-0.46; P=0.62) and (SMD=0.72; 95% CI: -0.01-1.45; P>0.05), respectively. However, a significant increase in TSH levels was observed at six months (SMD=0.54; 95% CI: 0.05-1.03; P=0.03). T4 levels showed no alteration at three months (SMD= -0.24; 95% CI: -0.56-0.08; P=0.14) but were reduced at four months (SMD= -0.79; 95% CI: -1.20--0.38; P=0.0001) and six months (SMD= -0.87; 95% CI: -1.57--0.17; P=0.01). T3 levels were reduced at three months (SMD= -0.42; 95% CI: -0.80--0.04; P=0.03), four months (SMD=-0.63; 95% CI: -1.03--0.23; P=0.002), and 6 months (SMD= -1.13; 95% CI: -1.77--0.55; P=0.0001).Conclusion
Long-term isotretinoin treatment may cause time-dependent changes in thyroid hormone levels.
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BibTeX
@article{alrubaiaan2026impact,
title = {{Impact of Isotretinoin Therapy on Thyroid Hormone Levels in Patients with Acne Vulgaris: A Systematic Review and Meta-Analysis.}},
author = {Mishari Tariq Alrubaiaan and Ajlan Hashim Alajlani and Raneem Alwatban and Abdulelah Nabil Alkadi and Hawra Fahad Alkhodairy and Fatimah Moayed Alalwan and Sarah Waleed Bin Rashid and Waleed Alajroush},
journal = {Dermatology practical \& conceptual},
year = {2026},
month = jul,
doi = {10.5826/dpc.1603a7403},
url = {https://europepmc.org/article/MED/42858442},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Impact of Isotretinoin Therapy on Thyroid Hormone Levels in Patients with Acne Vulgaris: A Systematic Review and Meta-Analysis.
AU - Mishari Tariq Alrubaiaan
AU - Ajlan Hashim Alajlani
AU - Raneem Alwatban
AU - Abdulelah Nabil Alkadi
AU - Hawra Fahad Alkhodairy
AU - Fatimah Moayed Alalwan
AU - Sarah Waleed Bin Rashid
AU - Waleed Alajroush
PY - 2026
DA - 2026/07/31
JO - Dermatology practical & conceptual
DO - 10.5826/dpc.1603a7403
UR - https://europepmc.org/article/MED/42858442
AB - Introduction Systemic isotretinoin is extensively used to treat moderate-to-severe acne vulgaris and may have systemic endocrine effects through the hypothalamic-pituitary-thyroid axis.Objectives To investigate the changes in thyroid hormone levels after commencement of systemic isotretinoin among patients with acne vulgaris.Methods A PubMed, ScienceDirect, Scopus, and Cochrane Library search was performed. Pooled analysis was conducted utilizing Review Manager (RevMan 5.4.1).Results A total of 447 patients from eight observational studies were included. After three and four months, no increase in TSH levels was observed following isotretinoin treatment with a standardized mean difference (SMD) of 0.09 (95% CI: -0.27-0.46; P=0.62) and (SMD=0.72; 95% CI: -0.01-1.45; P>0.05), respectively. However, a significant increase in TSH levels was observed at six months (SMD=0.54; 95% CI: 0.05-1.03; P=0.03). T4 levels showed no alteration at three months (SMD= -0.24; 95% CI: -0.56-0.08; P=0.14) but were reduced at four months (SMD= -0.79; 95% CI: -1.20--0.38; P=0.0001) and six months (SMD= -0.87; 95% CI: -1.57--0.17; P=0.01). T3 levels were reduced at three months (SMD= -0.42; 95% CI: -0.80--0.04; P=0.03), four months (SMD=-0.63; 95% CI: -1.03--0.23; P=0.002), and 6 months (SMD= -1.13; 95% CI: -1.77--0.55; P=0.0001).Conclusion Long-term isotretinoin treatment may cause time-dependent changes in thyroid hormone levels.
SN - 2160-9381
ER -