Severity of hair loss in Iranian acne patient during Isotretinoin treatment
Vali Anahita
Isfahan University of Medical science
Introduction:
Oral Isotretinoin (Accutane)is approved for the treatment of nodulocystic acne.Acutane side effects include dryness of skin and mucosa,cheilitis,nosebleed,conjunctivitis;hair loss.The aim of this study was to determine the severity of hair loss during acne treatment.
Methods:
Every patient that has undergone Accutane treatment for severe acne entered in this prospective clinical study.the patient were instructed to calculate the mean value of hair loss during 24 hours during three consecutive days.this measurement was done before treatment and at 4,8,12 and16 weeks of Accutane consumption.If the number of losed hair increased up to 30%,between30% to 70% or more than70%,we would considered it as mild,moderate and sever hair loss respectively.
Results:
43 patient from 14 to 42 years old involved in the study.After 16 weeks,hair loss increased in 33 cases(76.76%),decreased in 6 cases(13.95%) and 4 cases reported no difference in hair loss.
Repeated measure ANOVA showed that increase of hair loss was meaningful statistically(P<0.001) even after four weeks of Accutane consumption.pearson correlation coefficient showed that there was no meaningful correlation between age or sex and hair loss(P=0.2,and r=0.127).
Severity of hair loss was mild,moderate and sever in 25.6%,20.9%and 30.2% respectively.
Discussion:
Frequency of hair loss was 76.74% after 16 weeks Accutane treatment.in minority of patient(14%) hair loss decreased.More researches on this minority of patient may open new era in alopecia treatment.this paradoxical effects may be explained by personal variation in the type or distribution of retinoid receptors.Retinoid induced hair loss occurs via up regulation of Transforming growth factor bete 2 in the dermal papilla.Interpersonal variety in regulation of this receptor could explain different response of hair follicle to retinoid therapy.
Presnted as lecture in Razi congress of dermatology, 2007, abstract book 33.