Evaluation of the Efficacy and Adverse Effects of Isotretinoin in the Treatment of Acne Vulgaris, with a Focus on Psychological Impact in Low-Income Countries: A Cross-Sectional Study from Syria

Background and AimThis study aims to evaluate the effectiveness of isotretinoin in the treatment of acne, while also monitoring its associated physical and psychological adverse effects. Materials and MethodsA descriptive cross-sectional study was conducted using an online questionnaire distributed to individuals who are currently experiencing acne or have experienced it in the past. The questionnaire included items regarding acne severity, type and duration of treatment, adherence, side effects, and overall satisfaction. Data were statistically analyzed. ResultsA total of 377 participants, aged between 21 and 25 years, were included In the study. A significant Improvement was reported by 74.5% of users following isotretinoin treatment, while 4.8% noticed no improvement.Side effects were experienced by 91.2% of the participants. Physical side effectsThe most commonly reported side effects were dryness-- particularly of the lips, skin and eyes (82.8%, 75.9%, and 45.4%, respectively). Psychological side effects46.7% of participants reported symptoms such as anxiety, mood changes, depression, or even suicidal Ideation. Despite the side effects, 86.2% were satisfied with the treatments efficacy, while 19.9% discontinued the medication due to adverse effects. ConclusionsIsotretinoin is widely regarded as an effective treatment for moderate to severe cane. However, its use requires strict medical supervision before and during the treatment period due to Its wide range of potential physical and psychological adverse effects. The findings underscore the critical importance of comprehensive awareness among patients, physicians, and pharmacists regarding the potential risks--particularly psychological ones--that may escalate to suicidal tendencies in vulnerable individuals. This highlights the necessity for integrated management approaches that include regular medical and psychological monitoring. Given the persistent neglect of mental health In many communities, these results are concerning and call for increased public awareness and a shared responsibility among healthcare providers and patients. As for physical symptoms such as various forms of dryness, they can be detected early and managed medically. In some cases, dose adjustments or discontinuation may be necessary to prevent serious complications.