Strock D, Sivesind TE, Dellavalle RP, Mundinger GS. Isotretinoin Use in Transmasculine Patients and Its Implication on Chest
Masculinization Surgery: Scoping Review of the Literature.
JMIR Dermatol 2023;
6:e45351. [PMID:
37616418 PMCID:
PMC10450534 DOI:
10.2196/45351]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 06/29/2023] [Accepted: 07/23/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND
Acne often worsens in transmasculine patients who are on prolonged testosterone therapy. Isotretinoin is an oral retinoid used in the treatment of severe or refractory cases of acne, but it has the potential to cause delayed wound healing. Transmasculine patients may potentially be prescribed treatment for acne with isotretinoin while also planning to undergo chest masculinization surgery.
OBJECTIVE
This scoping review aims to determine whether isotretinoin has a negative impact on postoperative healing in transmasculine patients undergoing chest masculinization surgery.
METHODS
A scoping review was performed using the PubMed and Ovid databases. A total of 16 publications were selected for inclusion.
RESULTS
Acne tends to peak in transmasculine patients 6 months after initiation of testosterone treatment. Severe cases can be treated with isotretinoin; however, acne may recur once treatment is discontinued, given ongoing hormone therapy. There is little to no evidence in the medical literature regarding perioperative use of isotretinoin specifically among transmasculine patients undergoing chest masculinization surgery. In general, however, recent studies have found no evidence of increased hypertrophic scars or keloids in patients taking isotretinoin.
CONCLUSIONS
Further studies are required to strengthen the current evidence that suggests that isotretinoin does not need to be discontinued before or after incisional or excisional surgeries, including chest masculinization surgery in transmasculine patients.
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