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Neuropsychological and Psychiatric Outcomes During Isotretinoin Treatment in Adolescents With Acne Vulgaris: A Single‐Arm Prospective Cohort Study

Year: 2026

Type: article

Abstract: Background Acne vulgaris (AV) is a common condition in adolescents and is associated with significant psychosocial burden. Isotretinoin (ISO) is highly effective for AV, but concerns remain regarding its psychiatric and neurocognitive effects. This study aimed to evaluate the neuropsychological and psychiatric outcomes of ISO treatment in adolescents and to explore their associations with inflammatory markers. Although the psychiatric effects of ISO have been extensively investigated, comprehensive prospective studies evaluating both psychiatric and neuropsychological outcomes in adolescents with AV are limited. Therefore, this study aimed to comprehensively assess these domains during ISO treatment using a broad assessment battery. Methods In this prospective study, 78 adolescents aged 13–18 years with severe or treatment‐resistant AV were assessed at baseline and after 3 months of ISO treatment. Psychiatric status was evaluated using structured interviews (K‐SADS‐PL) and the RCADS‐CV. Neuropsychological performance was assessed using the Stroop Color Word Test, Visual‐Auditory Digit Span, and Digit Span Learning Test. Acne severity (GAGS) and inflammatory markers (NLR, PLR) were also measured. Results ISO treatment resulted in a significant reduction in acne severity without evidence of neuropsychological decline. A modest improvement in interference control was observed. Internalizing symptoms, particularly depressive and anxiety symptoms, increased during treatment, especially in the imputed analysis. No significant associations were found between inflammatory markers and neuropsychological or psychiatric outcomes. Conclusions ISO treatment in adolescents with AV appears to be neurocognitively safe, but internalizing symptoms increased during treatment. These findings highlight the importance of monitoring psychiatric symptoms during treatment. Further controlled studies are needed to confirm these results.

Source: Dermatologic Therapy

DOI: 10.1155/dth/3463004