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Standard Guidelines of Care: Performing Procedures in Patients on or Recently Administered with Isotretinoin

BACKGROUND: Currently, the standard protocol regarding the performance of procedures on patients receiving or having recently received isotretinoin (13-cis-retinoic acid) states that the procedures should not be performed. The recommendations in standard books and drug insert require discontinuation...

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Autores principales: Mysore, Venkataram, Mahadevappa, Omprakash H., Barua, Shyamanta, Majid, Imran, Viswanath, Vishalakshi, Bhat, Ramesh M., Talwar, Suresh, Thurakkal, Salim, Aurangabadkar, Sanjeev J., Chatterjee, Manas, Ganjoo, Anil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5820835/
https://www.ncbi.nlm.nih.gov/pubmed/29491653
http://dx.doi.org/10.4103/JCAS.JCAS_110_17
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author Mysore, Venkataram
Mahadevappa, Omprakash H.
Barua, Shyamanta
Majid, Imran
Viswanath, Vishalakshi
Bhat, Ramesh M.
Talwar, Suresh
Thurakkal, Salim
Aurangabadkar, Sanjeev J.
Chatterjee, Manas
Ganjoo, Anil
author_facet Mysore, Venkataram
Mahadevappa, Omprakash H.
Barua, Shyamanta
Majid, Imran
Viswanath, Vishalakshi
Bhat, Ramesh M.
Talwar, Suresh
Thurakkal, Salim
Aurangabadkar, Sanjeev J.
Chatterjee, Manas
Ganjoo, Anil
author_sort Mysore, Venkataram
collection PubMed
description BACKGROUND: Currently, the standard protocol regarding the performance of procedures on patients receiving or having recently received isotretinoin (13-cis-retinoic acid) states that the procedures should not be performed. The recommendations in standard books and drug insert require discontinuation of isotretinoin for 6 months before performing cosmetic procedures, including waxing, dermabrasion, chemical peels, laser procedures, or incisional and excisional cold-steel surgery. These recommendations have been followed for over two decades despite little evidence for the stated increased risk of scarring. OBJECTIVE: The Association of Cutaneous Surgeons (I) constituted a task force to review the evidence and to recommend consensus guidelines regarding the safety of skin procedures, including resurfacing, energy-device treatments, and dermatosurgical procedures in patients with concurrent or recent isotretinoin administration. MATERIALS AND METHODS: Data were extracted from the literature through a PubMed search using the keywords “isotretinoin,” “safety,” “scarring,” “keloids,” “hypertrophic scarring,” and “pigmentation.” The evidence was then labeled and circulated to all members of task force for review. RESULTS: The task force is of the opinion that there is insufficient evidence to support the current protocol of avoiding and delaying treatments in the patient group under consideration and recommends that the current practice should be discontinued. The task force concludes that performing procedures such as laser hair removal, fractional lasers for aging and acne scarring, lasers for pigmented skin lesions, fractional radio-frequency microneedling, superficial and medium-depth peels, microdermabrasion, dermaroller, biopsies, radio-frequency ablation, and superficial excisions is safe in patients with concurrent or recent isotretinoin administration.
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spelling pubmed-58208352018-02-28 Standard Guidelines of Care: Performing Procedures in Patients on or Recently Administered with Isotretinoin Mysore, Venkataram Mahadevappa, Omprakash H. Barua, Shyamanta Majid, Imran Viswanath, Vishalakshi Bhat, Ramesh M. Talwar, Suresh Thurakkal, Salim Aurangabadkar, Sanjeev J. Chatterjee, Manas Ganjoo, Anil J Cutan Aesthet Surg Guidelines BACKGROUND: Currently, the standard protocol regarding the performance of procedures on patients receiving or having recently received isotretinoin (13-cis-retinoic acid) states that the procedures should not be performed. The recommendations in standard books and drug insert require discontinuation of isotretinoin for 6 months before performing cosmetic procedures, including waxing, dermabrasion, chemical peels, laser procedures, or incisional and excisional cold-steel surgery. These recommendations have been followed for over two decades despite little evidence for the stated increased risk of scarring. OBJECTIVE: The Association of Cutaneous Surgeons (I) constituted a task force to review the evidence and to recommend consensus guidelines regarding the safety of skin procedures, including resurfacing, energy-device treatments, and dermatosurgical procedures in patients with concurrent or recent isotretinoin administration. MATERIALS AND METHODS: Data were extracted from the literature through a PubMed search using the keywords “isotretinoin,” “safety,” “scarring,” “keloids,” “hypertrophic scarring,” and “pigmentation.” The evidence was then labeled and circulated to all members of task force for review. RESULTS: The task force is of the opinion that there is insufficient evidence to support the current protocol of avoiding and delaying treatments in the patient group under consideration and recommends that the current practice should be discontinued. The task force concludes that performing procedures such as laser hair removal, fractional lasers for aging and acne scarring, lasers for pigmented skin lesions, fractional radio-frequency microneedling, superficial and medium-depth peels, microdermabrasion, dermaroller, biopsies, radio-frequency ablation, and superficial excisions is safe in patients with concurrent or recent isotretinoin administration. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5820835/ /pubmed/29491653 http://dx.doi.org/10.4103/JCAS.JCAS_110_17 Text en Copyright: © 2018 Journal of Cutaneous and Aesthetic Surgery http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Guidelines
Mysore, Venkataram
Mahadevappa, Omprakash H.
Barua, Shyamanta
Majid, Imran
Viswanath, Vishalakshi
Bhat, Ramesh M.
Talwar, Suresh
Thurakkal, Salim
Aurangabadkar, Sanjeev J.
Chatterjee, Manas
Ganjoo, Anil
Standard Guidelines of Care: Performing Procedures in Patients on or Recently Administered with Isotretinoin
title Standard Guidelines of Care: Performing Procedures in Patients on or Recently Administered with Isotretinoin
title_full Standard Guidelines of Care: Performing Procedures in Patients on or Recently Administered with Isotretinoin
title_fullStr Standard Guidelines of Care: Performing Procedures in Patients on or Recently Administered with Isotretinoin
title_full_unstemmed Standard Guidelines of Care: Performing Procedures in Patients on or Recently Administered with Isotretinoin
title_short Standard Guidelines of Care: Performing Procedures in Patients on or Recently Administered with Isotretinoin
title_sort standard guidelines of care: performing procedures in patients on or recently administered with isotretinoin
topic Guidelines
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5820835/
https://www.ncbi.nlm.nih.gov/pubmed/29491653
http://dx.doi.org/10.4103/JCAS.JCAS_110_17
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