High dose retinoids, such as isotretinoin, have been used as a treatment for severe acne for decades. The treatment results are positive; however they come with heavy consequences. Vitamin A is stored in the liver and can become toxic when given for long periods of time at high doses. Retinoid treatment for acne can lead to increased liver enzymes and alterations in cholesterol and triglycerides. Other changes associated with retinoid toxicity include dryness of the skin on the face, cheilitis (cracking of corners of mouth) and facial redness. Studies from the late 1990’s showed promising effects of combining Vitamin E with retinoid treatment to reduce the occurrence of side effects.
The International Journal of Dermatology published a study in March 2005 that attempted to demonstrate the protective effects of Vitamin E on retinoid toxicity. The study enrolled 82 participants (men and women) with active moderate to severe acne. The participants were put on a daily regimen of isotretinoin 1mg/kg/day. Then they were randomized to receive 800 IU of Vitamin E (alpha-tocopherol) or placebo for 16 weeks.
The primary outcome measurements were serum lipids (cholesterol and triglycerides) and liver enzymes. Changes in skin texture, dryness, and color were also assessed.
The research found no significant differences between the groups receiving Vitamin E with the isotretinoin versus isotretinoin alone. The authors concluded that this study cannot support the claim that Vitamin E therapy decreases or protects against the side effects caused by high dose retinoid therapy for moderate to severe forms of acne.
The results of this study prompt a need for review of prior studies that showed benefit. It is possible that the length of this study was not adequate or that the dosage of Vitamin E suggested was not adequate.
Posted by Kristopher Foster on January 23, 2006 09:47 AM
