Comparative study between Isotretinoin alone versus Isotretinoin combined with either Levocetirizine or Desloratadine in the treatment of acne Vulgaris

Background: Many studies have proved isotretinoin&#039;s effectiveness in the treatment of acne. However, because of the potential for mucocutaneous side effects and acne outbreaks, it should be used and monitored with caution. To avoid undesired side effects, not only different dosing regimens being established, but also new options for decreasing sebum, such as antihistaminic medications. The aim of the work: This study aims to assess the efficacy and negative impacts of isotretinoin as a single therapy compared to its combination with Levocetirizine or Desloratadine in managing moderate to severe acne. Patients and methods: This study is a Randomized clinical trial that included 60 moderate to severe acne patients. It was implemented in the dermatology department at Al-Azhar university hospital in Damietta. Patients were randomized into three matched groups; Group A (n=20); which included patients received isotretinoin alone, Group B (n=20); which included patients received isotretinoin and levocetirizine. Group C (n=20); which included patients received isotretinoin and Desloratadine. The primary outcomes of the study were Global Acne Grading System (GAGS), inflammatory, non-inflammatory and total lesion counts. Results: By comparing the three study groups as regards the GAGS, we found a significant difference between Isotretinoin alone group and the both groups of Isotretinoin-Antihistaminic combination after 3 months of treatment (P <0.05). As regard to lesions count, we found a statistically significant difference of the mean inflammatory and total acne lesion count between Isotretinoin alone group and the both groups of Isotretinoin-Antihistaminic combination at all 3 the treatment intervals. Conclusion: The findings of this study show that the combination of oral antihistamines (desloratadine or levocetirizine) with oral isotretinoin produces better outcomes and advantages compared to using isotretinoin alone, in terms of both efficacy and tolerability.