Isotretinoin for Acne in Transgender and Gender-Diverse Individuals Receiving Masculinizing Hormone Therapy Article Swipe
James Choe
,
Ali Shields
,
Alana Ferreira
,
Sarah Gold
,
Jeromy W. Gotschall
,
Kanika Kamal
,
Austin Rios
,
Robin H. Wang
,
Emily Baumrin
,
Erica D. Dommasch
,
Howa Yeung
,
Jules B. Lipoff
,
John S. Barbieri
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1001/jamadermatol.2024.1420
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1001/jamadermatol.2024.1420
Importance Masculinizing gender-affirming hormonal therapy is associated with the development of acne. While isotretinoin is a highly effective acne treatment, little is known about its effectiveness and safety among transgender and gender-diverse individuals receiving gender-affirming hormonal therapy. Objective To evaluate clinical outcomes of isotretinoin among transgender and gender-diverse individuals receiving gender-affirming hormonal therapy. Design, Setting, and Participants This multicenter retrospective case series study was conducted at 4 medical centers: Mass General Brigham, University of Pennsylvania, Emory University, and Fenway Health. It included patients aged between 12 and 49 years who were receiving masculinizing gender-affirming hormonal therapy and prescribed isotretinoin for the management of acne between August 14, 2015, and September 20, 2023. Exposure Isotretinoin therapy for the management of acne. Main Outcomes and Measures The percentage of patients experiencing improvement or clearance of acne, as well as rates of acne recurrence. Adverse effects and reasons for treatment discontinuation were also evaluated. Results Among 55 included patients, the mean (SD) age was 25.4 years; 4 (7.3%) were Asian, 2 (3.6%) were Black, 4 (7.2%) were Hispanic, 1 was (1.8%) multiracial, and 36 (65.5%) were White. The median isotretinoin course duration was 6 months (IQR, 4.0-8.0), with a median cumulative dose of 132.7 mg/kg (IQR, 66.4-168.5); the cumulative dose was less than 90 mg/kg for 16 patients (29.1%) and less than 120 mg/kg for 22 patients (40.0%). Isotretinoin was associated with improvement in 48 patients (87.3%) and clearance in 26 patients (47.3%). For the 33 patients treated with a cumulative dose of 120 mg/kg or more, these rates increased to 32 patients (97.0%) and 21 patients (63.6%), respectively. Among the 20 patients who achieved acne clearance and had any subsequent health care encounters, the risk of recurrence was 20.0% (n = 4). The most frequently reported adverse effects were dryness (n = 44; 80.0%), joint pain (n = 8; 14.5%), and eczema (n = 5; 9.1%). Laboratory abnormalities were uncommon. Reasons for premature treatment discontinuation included cost, pharmacy issues, adverse effects, logistical reasons (scheduling), and wound healing concerns for gender-affirming surgery. Conclusion and Relevance In this case series study of individuals with acne who were receiving masculinizing gender-affirming hormonal therapy and underwent isotretinoin treatment, isotretinoin was often effective and well tolerated. However, premature treatment discontinuation was common and associated with poorer outcomes. Further efforts are needed to understand optimal dosing and treatment barriers to improve outcomes in transgender and gender-diverse individuals receiving masculinizing gender-affirming hormonal therapy.
Related Topics
Concepts
Isotretinoin
Medicine
Acne
Discontinuation
Adverse effect
Hormone therapy
Transgender
Hormonal therapy
Internal medicine
Dermatology
Cancer
Breast cancer
Psychoanalysis
Psychology
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1001/jamadermatol.2024.1420
- OA Status
- green
- Cited By
- 4
- References
- 14
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4399128497
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4399128497Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1001/jamadermatol.2024.1420Digital Object Identifier
- Title
-
Isotretinoin for Acne in Transgender and Gender-Diverse Individuals Receiving Masculinizing Hormone TherapyWork title
- Type
-
articleOpenAlex work type
- Language
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enPrimary language
- Publication year
-
2024Year of publication
- Publication date
-
2024-05-29Full publication date if available
- Authors
-
James Choe, Ali Shields, Alana Ferreira, Sarah Gold, Jeromy W. Gotschall, Kanika Kamal, Austin Rios, Robin H. Wang, Emily Baumrin, Erica D. Dommasch, Howa Yeung, Jules B. Lipoff, John S. BarbieriList of authors in order
- Landing page
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https://doi.org/10.1001/jamadermatol.2024.1420Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
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greenOpen access status per OpenAlex
- OA URL
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https://www.ncbi.nlm.nih.gov/pmc/articles/11137662Direct OA link when available
- Concepts
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Isotretinoin, Medicine, Acne, Discontinuation, Adverse effect, Hormone therapy, Transgender, Hormonal therapy, Internal medicine, Dermatology, Cancer, Breast cancer, Psychoanalysis, PsychologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
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4Total citation count in OpenAlex
- Citations by year (recent)
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2025: 1, 2024: 3Per-year citation counts (last 5 years)
- References (count)
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14Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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