Isotretinoin Beyond the Skin: A Prospective Study on Its Impact on Periodontal Health

Background: Isotretinoin is a systemic retinoid widely used for the treatment of severe acne vulgaris. While its dermatologic side effects are well known, its potential impact on periodontal health has not been fully elucidated. Objective: This prospective study aimed to evaluate the effects of systemic isotretinoin therapy on clinical periodontal parameters in young adults treated for acne vulgaris. Methods: A total of 80 patients (59 females and 21 males), aged between 18 and 25 years, undergoing systemic isotretinoin therapy (0.5 mg/kg/day for months 0–3 and 0.7 mg/kg/day for months 4–6) for a duration of six months, were included in the study. Clinical periodontal assessments, including bleeding on probing (BOP), plaque index (PI), and probing depth (PD), were performed at baseline and after six months. Patients with systemic conditions, recent dental treatments or antibiotic use, and other potential confounding factors were excluded. Data were analyzed using the Wilcoxon signed-rank test, McNemar test, and regression analysis. Results: Posttreatment assessments showed a significant increase in the prevalence of BOP (from 18.8% to 48.8%, P<0.001). The mean PI increased from 1.06 ± 1.24 to 1.26 ± 1.25 (P=0.007), while the mean PD rose from 1.25 ± 1.06 mm to 1.73 ± 1.08 mm (P<0.001). No significant association was found between changes in periodontal parameters and age or sex, as determined by regression analysis. Conclusion: Isotretinoin therapy may contribute to subclinical deterioration in periodontal health, as evidenced by increased BOP, PI, and PD values. Although these changes were modest, clinicians prescribing isotretinoin should consider potential oral health implications and advise patients accordingly. For dermatologists, incorporating basic periodontal screening into routine care may help identify at-risk patients early.