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TOPLINE:

Isotretinoin treatment for acne during adolescence was not associated with clinically meaningful reductions in adult height in a large Danish study.

METHODOLOGY:

• Researchers conducted a nationwide population-based cross-sectional study in Denmark of 379,196 individuals (10,858 women) eligible for military conscription between January 2001 and December 2015.
• Participants were grouped as users of isotretinoin (16,739 male and 278 female), oral tetracycline-class antibiotics (≥ 90 tablets within 6 months), topical acne therapy, or no acne treatment.
• The primary outcome was adult height measured at conscription (median age 19.0 years for male, 19.2 years for female), with a predefined minimal clinically important difference of ≥ 5 cm.
• The secondary outcome was stunting, defined as a height ≤ 2 SD compared with the height of individuals of the same sex and age (rounded to full years) in the study population.

TAKEAWAY:

• The adjusted mean difference (AMD) in height among isotretinoin users was 0.31 cm in men (95% CI, 0.20-0.41 cm) and 0.25 cm in women (95% CI, -0.47 to 0.96 cm), both below the minimal clinically important threshold.
• Height was slightly reduced in men who started isotretinoin before age 13 (AMD, -1.70 cm; 95% CI, -3.15 to -0.25 cm), but the difference was below the threshold for clinical relevance.
• No dose-response association was seen between cumulative isotretinoin dose at conscription or before age 15 and adult height in men (median, 5000 and 4000 mg, respectively) and women (median, 4750 and 3500 mg, respectively).
• Compared with no acne treatment, isotretinoin use was associated with less stunting in men (2.14% vs 1.51%, respectively; adjusted prevalence ratio, 0.72; 95% CI, 0.63-0.81), with a small absolute difference.

IN PRACTICE:

“In this nationwide population-based cross-sectional study, we found that isotretinoin prescribed for acne in adolescence was not associated with a clinically meaningful reduction in adult height,” the authors of the study wrote. “Given the substantial psychosocial burden of moderate-to-severe acne,” they added, “these findings may provide reassurance for clinicians, patients, and families and support shared evidence-based decision-making when isotretinoin therapy is considered during adolescence.”

SOURCE:

The study was led by Sigrún Alba Jóhannesdóttir Schmidt, MD, PhD, Aarhus University and Aarhus University Hospital, Aarhus, Denmark, and was published online on May 20 in JAMA Dermatology.

LIMITATIONS:

The study was limited by a small number of women who initiated isotretinoin before age 13; the absence of repeated anthropometric measurements; and lack of information on individual pubertal timing, nutritional status, and parental height. The results may not be generalizable to other populations.

DISCLOSURES:

The project received funding from the Aage Bangs Foundation, Fonden til Laegevidenskabens Fremme, and the Health Research Foundation of Central Denmark Region. Schmidt disclosed receiving personal fees from GSK Pharma Consulting Inc. Several other authors also reported receiving personal fees and grants from various organizations and healthcare companies. Additional disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.