Acne, isotretinoin and depression

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Abstract
At any one time, most 16-18-year-olds and up to half of adults have acne.1 In 60% of all teenagers, the condition will be sufficiently severe for them to self-treat or seek medical advice.2 Up to half of 12-20-year-olds with acne develop psychological or social problems.3 Oral isotretinoin, which is used for the treatment of severe acne,4 might be expected to improve psychological functioning.5,6 However, there have been suggestions that the drug itself might cause depression and suicide.7 Here we consider these concerns, and the implications for the use of isotretinoin when managing patients of all ages.