Journal of Asia Pacific Aesthetic Sciences

Abstract: Acne vulgaris is a common dermatology disorder affecting adolescent with potential for profound psychosocial morbidity. There is high prevalence rate of depression and anxiety among patients with acne. In this case, an 18-year-old gentleman diagnosed to have acne vulgaris with the severity of CASS 4 was initially treated with isotretinoin. Unfortunately, post initiation of isotretinoin, he suffered from depressive symptoms that resulted in early termination of isotretinoin. Although he was able to recover from his depressive symptoms after the termination of isotretinoin, he was unable to tolerate topical benzoyl peroxide (BPO) 5% and had to be admitted for intravenous antibiotics and steroid. Therefore, despite isotretinoin being the most efficacious in treatment of severe acne, conflicting results of its association with depression still require more controlled trials to clarify. In this case, it is highlighted that even a low dose isotretinoin might cause significant psychological impact that warranted more caution in treatment of acne.