Characteristics of Patients with Hair Loss after Isotretinoin Treatment: A Retrospective Review Study

BACKGROUND: Oral isotretinoin has been used to treat acne for decades. Although the side effects of isotretinoin are mostly predictable, one less common side effect of isotretinoin use is hair loss, typically telogen effluvium. OBJECTIVE: This study is a retrospective report on the development of alopecia in patients on isotretinoin therapy. METHODS: To characterize these patients, they were further compared to other patients in the same time period who were prescribed isotretinoin and did not experience hair loss. RESULTS: Of 6330 patients with hair loss, 48 had been prescribed isotretinoin at some time between 2013 and 2018. Of these 48 patients, hair loss occurred concurrently or within two years after taking isotretinoin in 19 patients. When compared to controls, patients who experienced hair loss from isotretinoin were older, had greater cumulative isotretinoin doses, and had longer durations of treatment. CONCLUSION: Although the exact mechanism of how retinoids affect hair loss is still unclear, our findings suggest dosage or duration of usage may be associated. This information may be useful in counseling patients who may be concerned about hair loss when considering isotretinoin treatment.