Acne Medicine & Depression

Acne can cause increased rates of depression in adolescents.

Isotretinoin, commonly known as Accutane or Roaccutane, is a medication approved for cases of severe acne. It is often effective for acne which has been resistant to other treatments, however, it can have severe side effects. Severe birth defects have been reported as a result of pregnant women taking isotretinoin and some claim this medication is linked to depression, though many studies have not been able to establish a causal link.

About Isotretinoin

Isotretinoin is very similar to the structure of vitamin A; however, its mechanism of action is poorly understood. It may reduce sebum, an oily substance secreted by the skin, which can cause or exacerbate acne. It is a very powerful drug that is used after other treatments have failed to be effective. It is usually only prescribed for severe cases of acne.

About Depression

Depression is a psychiatric disorder characterized by prolonged sad or depressed mood. Other symptoms of depression may include suicidal ideation and excessive feelings of guilt or worthlessness. Depression may affect the body, causing weight gain or loss, overeating or lack of appetite, and oversleeping or insomnia. Depression is a very common but serious illness, and can be especially serious in adolescents. Depression can be treated with psychotherapy and medication, and often a combination of the two is most effective.

Isotretinoin and Depression

A review of nine studies that looked at patients treated with isotretinoin found that although some patients did suffer from depression, there was no causal link between the drug and depressive symptoms. Another study of 20,000 people in Canada and Britain who suffered from acne showed no evidence that isotretinoin was associated with suicidal ideation, depression or any other psychiatric disorder.

Severe Acne and Depression

Isotretinoin may have some positive psychological effects if it is effective in treating acne because acne itself may have considerable negative psychological consequences. A study of more than two thousand high school students found that acne was related to higher levels of anxiety, especially in girls. A study of nine thousand New Zealand adolescents found that acne increases the risk for depression, anxiety and suicide attempts.

Considerations

Although isotretinoin has not been conclusively linked to depression or suicide attempts, it is important to monitor anyone taking this medication and provide psychiatric intervention if necessary. Isotretinoin is a powerful medication and should only be used in severe cases of acne where other medications have not been effective. The best way to consider the risks and benefits of isotretinoin is to consult with a dermatologist.

References

• National Institute of Mental Health; What are the signs and symptoms of depression
• "Archives of Dermatology"; Isotretinoin Use and Risk of Depression, Psychotic Symptoms, Suicide, and Attempted Suicide
• "Seminars in Cutaneous Medicine and Surgery"; Depression and Suicidal Behavior in Acne Patients Treated With Isotretinoin: A Systematic Review
• "International Journal of Dermatology"; Anxiety, depression, and acne vulgaris in adolescents
• "Journal of Pediatrics and Child Health"; Acne, anxiety, depression and suicide in teenagers: A cross-sectional survey of New Zealand secondary school students