In treating severe acne, isotretinoin is used commonly. But there are several possible side effects, including liver damage, depression and severe birth defects if used during pregnancy. Derived from vitamin A, the drug reduces size of sebaceous glands in skin and lessens amount of oil produced. This, according to common belief, reduces bacteria levels in oily skin regions and tones down inflammation. Researchers studying this published their findings in Journal of Investigative Dermatology which suggest that isotretinoin alters skim microbiome. Lead author of study, Dr. William H. McCoy said that certain greasy parts of skin support growth of particular bacterial communities, some of which seem to be linked to acne. Study includes finding if isotretinoin reduces growth of such bacteria, particularly Cutibacterium acnes or Propionibacterium acnes (former name).
17 individuals suffering from acne and who were treated with isotretinoin were studied. 8 individuals, 4 with and 4 without acne formed the control group. None of the 8 individuals received any treatment. Skin samples from face were collected from these people over 10 months on 4 occasions. Dr. McCoy explained that isotretinoin was found to actually reduce number of C. acnes. It was also seen that diversity of bacteria on skin surface had increased, none of which had associations with acne previously. Findings hence indicated that isotretinoin alters growth conditions in skin and favors more diverse bacterial population instead of directly altering bacteria number present. Even after treatment was stopped, effect continued and oil production normalized. Makedonka Mitreva said that the diversity of bacterial populations after treatment appeared to be healthier.
Understanding the working of isotretinoin will help the team in developing better treatment methods for acne. Dr. McCoy said that some kind of ‘week killer’ or microbial ‘fertilizer’ could be applied to skin for promoting healthy microbes growth. This could help pregnant women with intense acne a great deal and others who use isotretinoin.