Comparison of depression, anxiety and life quality in acne vulgaris patients who were treated with either isotretinoin or topical agents

Int J Dermatol. 2009 Jan;48(1):41-6. doi: 10.1111/j.1365-4632.2009.03806.x.


Background: Since the introduction of isotretinoin to the market, many adverse psychiatric effects, including depression, anxiety and suicide attempts were reported. The aim of this study was to determine whether patients with acne who were treated with isotretinoin experienced significant increases in psychiatric symptoms over a 4-month period compared with patients who received topical acne therapy.

Methods: Seventy-eight acne patients were allocated either to isotretinoin treatment (study group) (n = 37) or to topical treatment (control group) (n = 41). Their psychological status was evaluated at the baseline, second and fourth months of the treatment. All patients were required to complete the dermatology life quality index (DLQI), the Hospital anxiety and depression (HAD) scale, and the beck depression inventory (BDI).

Results: The two groups were not different from each other in terms of DLQI, BDI, HAD-A, HAD-D and total HAD scores at baseline. However, at the end of the second month quality of life was more impaired in the topical treatment group compared to the isotretinoin group (P < 0.05), and there were no difference between two groups in terms of BDI, HAD-A, HAD-D, and total HAD scores (P > 0.05). At the end of fourth month quality of life and all psychological test scores had improved more in the isotretinoin group compared to topical treatment group (P < 0.05).

Conclusion: Results of the present study indicate that there is no increase in depressive and anxiety symptoms in the isotretinoin treatment group compared to that in the topical group. Instead, successful treatment of acne seems to improve both depressive and anxiety symptoms and improve quality of life.

Publication types

  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Acne Vulgaris / diagnosis
  • Acne Vulgaris / drug therapy*
  • Acne Vulgaris / psychology*
  • Administration, Oral
  • Administration, Topical
  • Adolescent
  • Adult
  • Age Factors
  • Anti-Bacterial Agents / administration & dosage
  • Anxiety / epidemiology
  • Anxiety / etiology*
  • Depression / epidemiology
  • Depression / etiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Isotretinoin / administration & dosage*
  • Male
  • Prevalence
  • Probability
  • Prospective Studies
  • Quality of Life*
  • Risk Assessment
  • Severity of Illness Index
  • Sex Factors
  • Statistics, Nonparametric
  • Young Adult


  • Anti-Bacterial Agents
  • Isotretinoin