A Review of the Misuse of Isotretinoin in South Africa
Abstract
Isotretinoin is a potent retinoid drug that is primarily used for the treatment of severe acne. Because of this the drug has attracted attention and has the potential for abuse and misuse. This review manuscript aims to explore the dimensions of isotretinoin abuse in South Africa. Discussed herein are the epidemiological trends, underlying motivations and associated health risks of Isotretinoin.
The sociocultural and economic factors that contribute to this abuse is explored. Furthermore, Isotretinoin is rather perceived as a cosmetic enhancement tool, while it has controlled its accessibility. Hence, the regulatory framework that governs the access to controlled substances such as isotretinoin in South Africa is analysed and the gaps and enforcement challenges that allow for the misuse are explored.
Isotretinoin remains an valuable drug in the management of severe acne. However, its potential for abuse in South Africa requires a comprehensive approach involving healthcare professionals, policymakers, and the public to ensure safe and appropriate use through implementing innovative rational medicine use (RMU) interventions that aim to protect public health while ensuring access for those with sincere need.
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2. Foti C, Calogiuri G, Nettis E, et al. Allergic contact dermatitis from vitamins: A systematic review. Health Sci Rep. 2022;5(6):e766.
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10. Lam M, Hu A, Fleming P, Lynde CW. The impact of acne treatment on skin bacterial microbiota: a systematic review. J Cutan Med Surg. 2022;26(1):93-97.
11. Sharma S, Vashist S, Lamba AK, Arora S. Novel Strategies in the Treatment of Acne: A Review. International Journal of Pharmaceutical Investigation. 2022;12(2):123-8.
12. Huang B, Dawson DA, Stinson FS, et al. Prevalence, correlates, and comorbidity of nonmedical prescription drug use and drug use disorders in the United States: results of the National Epidemiologic Survey on alcohol and related conditions [CME]. J Clin Psychiatry. 2006;67(7):1062-73.
13. Barlow M, Connolly C, Godfrey T, Plean J. Prescription Drug Abuse. Symposium Discoveryday. Long Island University (Poster). 2018; 12. Available from: https://digitalcommons.liu.edu/cgi/viewcontent.cgi?article=1012&context=symposium_discoveryday [Accessed: 2024/12/12]
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15. Villani A, Nastro F, Di Vico F, Fabbrocini G, Annunziata MC, Genco L. Oral isotretinoin for acne: a complete overview. Expert Opin Drug Saf.. 2022;21(8):1027-37.
16. Al-Mekhlafi R, Attiyah RE, Haddad YR, Salah LA. Awareness on teratogenic effects of isotretinoin and compliance with precautionary measures among women of childbearing age in Makkah Province, Saudi Arabia. Obstet Gynecol Int. 2021;2021:9966300.
17. Sarayani A, Albogami Y, Thai TN, et al. Prenatal exposure to teratogenic medications in the era of Risk Evaluation and Mitigation Strategies. Am J Obstet Gynecol. 2022;227(2):263.e1.
18. Barbieri JS, Shin DB, Wang S, Margolis DJ, Takeshita J. Association of race/ethnicity and sex with differences in health care use and treatment for acne. JAMA dermatol. 2020;156(3):312-9.
19. Mokwatlo K. Needs assessment of psychocutaneous medicine amongst dermatology practitioners in South Africa [dissertation]. Electronic theses and dissertation (EDT) collectin: University of Witwatersrand; 2022.
20. Sharma A, Upadhyay DK, Gupta GD, Narang RK, Rai VK. IL-23/Th17 axis: a potential therapeutic target of psoriasis. Curr Drug Res Rev. 2022;14(1):24-36.
21. Botsali A, Uran P. The effects of isotretinoin on affective and cognitive functions are disparate in adolescent acne vulgaris patients. J Dermatolog Treat. 2020;31(7):734-8.
22. Lagacé F, D’Aguanno K, Prosty C, et al. The Role of Sex and Gender in Dermatology-From Pathogenesis to Clinical Implications. J Cutan Med Surg. 2023;27(4):NP1-36.
23. Serra MS, Aguinaga F. Skin disorders in transgender patients. in dermatology in public health environments: a comprehensive textbook 2023 Apr 1 (pp. 1405-1411). Cham: Springer International Publishing.
24. Breetzke GD. Crime and spatiality in South African cities. Urban geography in South Africa. Perspectives and theory. 2020:155-72.
25. Enaifoghe A, Dlelana M, Durokifa AA, Dlamini NP. The prevalence of gender-based violence against women in South Africa: A call for action. African Journal of Gender, Society & Development. 2021;10(1):117
26. Al Muqarrab F, Almohssen A. Low‐dose oral isotretinoin for the treatment of adult patients with mild‐to‐moderate acne vulgaris: Systematic review and meta‐analysis. Dermatol Ther. 2022;35(4):e15311.
27. Layton AM, Thiboutot D, Tan J. Reviewing the global burden of acne: how could we improve care to reduce the burden?. Br J Dermatol. 2021;184(2):219-25.
28. Corcoran L, Muller I, Layton AM, et al. Systematic review of clinical practice guidelines for acne vulgaris published between January 2017 and July 2021. Skin Health Dis. 2023;3(4):e240.
29. Davids LM, Van Wyk J, Khumalo NP, Jablonski NG. The phenomenon of skin lightening: Is it right to be light?. South African Journal of Science. 2016;112(11-12):1-5.
30. Lince-Deroche N, Hendrickson C, Moolla A, Kgowedi S, Mulongo M. Provider perspectives on contraceptive service delivery: findings from a qualitative study in Johannesburg, South Africa. BMC Health Serv Res. 2020;20(1):128.
31. Weld ED, Bailey TC, Waitt C. Ethical issues in therapeutic use and research in pregnant and breastfeeding women. Br J Clin Pharmacol. 2022;88(1):7-21.
32. Kocyigit S, Sahin M, Houshyar Y, Dost günay FA, Çorapçioğlu D. Effects of isotretinoin treatment on levels of hormones involved in the etiopathogenesis of acne. Turkish Journal of Endocrinology and Metabolism. 2020;24(3):237-46.
33. Awadhalla F, Jaber M, Alfalasi H, Hallak Y. Rhabdomyolysis in a Physically Active Patient on Isotretinoin Therapy: A Case Report. Case Reports and Reviews. 2024;4(1):1-2.
34. Syed MF, Rehmani A, Yang M. Ocular side effects of common systemic medications and systemic side effects of ocular medications. Med Clin North Am. 2021;105(3):425-44.
35. Kapała J, Lewandowska J, Placek W, Owczarczyk-Saczonek A. Adverse events in isotretinoin therapy: a single-arm meta-analysis. Int J Environ Res Public Health. 2022;19(11):6463.
36. Bunick CG, Teng JM, Guenthner S, et al. Characteristics and outcomes for participants with congenital ichthyosis who responded to treatment with the topical isotretinoin formulation TMB-001: results from the Phase IIb CONTROL study. Clin Exp Dermatol. 2023;48(7):765-9.
37. Jarab AS, Al-Azzam SI, Al-Mutairi S, et al. Community pharmacists’ knowledge and awareness about isotretinoin therapy and its dispensing practice in Jordan. Heliyon. 20231;9(11):e22354.
38. Kruger UV. A retrospective analysis of the prescribing patterns of isotretinoin [dissertation]. South Africa, Potchefstroom: North-West University; 2008.
39. Lugani T, Nagpal M, Malik DS, Sharma A, Puri V, Dhingra GA. Nanocarriers as Prospective Approach in Effective Management of Acne Vulgaris. Micro and Nanosystems. 2021;13(3):253-66.
40. Dabash D, Salahat H, Awawdeh S, et al. Prevalence of acne and its impact on quality of life and practices regarding self-treatment among medical students. Sci Rep. 2024;14(1):4351.
2. Foti C, Calogiuri G, Nettis E, et al. Allergic contact dermatitis from vitamins: A systematic review. Health Sci Rep. 2022;5(6):e766.
3. Leung AK, Barankin B, Lam JM, Leong KF, Hon KL. Dermatology: how to manage acne vulgaris. Drugs Context. 2021:10:2021-8-6.
4. Reynolds RV, Yeung H, Cheng CE, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2024;90(5):1006.
5. Bagatin E, Costa CS. The use of isotretinoin for acne - an update on optimal dosing, surveillance, and adverse effects. Expert Rev Clin Pharmacol. 2020;13(8):885-97.
6. Alshammari E. Efficacy of Generic vs. branded Isotretinoin for Acne treatment: a case report. Journal of Advanced Pharmacy Education and Research. 2021;11(1-2021):125-7. 7. Barlow R, Payyazhi G, Hogan S, et al. Suicide and suicidality in children and adolescents with chronic skin disorders: a systematic review. Acta Derm Venereol. 2023;103:adv00851.
8. Öztekin C, Öztekin A. The association of depression, loneliness and internet addiction levels in patients with acne vulgaris. Biopsychosoc Med. 2020;14:17.
9. McLane J. Analysis of common side effects of isotretinoin. J Am Acad Dermatol. 2001;45(5):S188-94.
10. Lam M, Hu A, Fleming P, Lynde CW. The impact of acne treatment on skin bacterial microbiota: a systematic review. J Cutan Med Surg. 2022;26(1):93-97.
11. Sharma S, Vashist S, Lamba AK, Arora S. Novel Strategies in the Treatment of Acne: A Review. International Journal of Pharmaceutical Investigation. 2022;12(2):123-8.
12. Huang B, Dawson DA, Stinson FS, et al. Prevalence, correlates, and comorbidity of nonmedical prescription drug use and drug use disorders in the United States: results of the National Epidemiologic Survey on alcohol and related conditions [CME]. J Clin Psychiatry. 2006;67(7):1062-73.
13. Barlow M, Connolly C, Godfrey T, Plean J. Prescription Drug Abuse. Symposium Discoveryday. Long Island University (Poster). 2018; 12. Available from: https://digitalcommons.liu.edu/cgi/viewcontent.cgi?article=1012&context=symposium_discoveryday [Accessed: 2024/12/12]
14. Ibrahim SM, Farag A, Hegazy R, Mongy M, Shalaby S, Kamel MM. Combined low‐dose isotretinoin and pulsed dye laser versus standard‐dose isotretinoin in the treatment of inflammatory acne. Lasers Surg Med. 2021;53(5):603-9.
15. Villani A, Nastro F, Di Vico F, Fabbrocini G, Annunziata MC, Genco L. Oral isotretinoin for acne: a complete overview. Expert Opin Drug Saf.. 2022;21(8):1027-37.
16. Al-Mekhlafi R, Attiyah RE, Haddad YR, Salah LA. Awareness on teratogenic effects of isotretinoin and compliance with precautionary measures among women of childbearing age in Makkah Province, Saudi Arabia. Obstet Gynecol Int. 2021;2021:9966300.
17. Sarayani A, Albogami Y, Thai TN, et al. Prenatal exposure to teratogenic medications in the era of Risk Evaluation and Mitigation Strategies. Am J Obstet Gynecol. 2022;227(2):263.e1.
18. Barbieri JS, Shin DB, Wang S, Margolis DJ, Takeshita J. Association of race/ethnicity and sex with differences in health care use and treatment for acne. JAMA dermatol. 2020;156(3):312-9.
19. Mokwatlo K. Needs assessment of psychocutaneous medicine amongst dermatology practitioners in South Africa [dissertation]. Electronic theses and dissertation (EDT) collectin: University of Witwatersrand; 2022.
20. Sharma A, Upadhyay DK, Gupta GD, Narang RK, Rai VK. IL-23/Th17 axis: a potential therapeutic target of psoriasis. Curr Drug Res Rev. 2022;14(1):24-36.
21. Botsali A, Uran P. The effects of isotretinoin on affective and cognitive functions are disparate in adolescent acne vulgaris patients. J Dermatolog Treat. 2020;31(7):734-8.
22. Lagacé F, D’Aguanno K, Prosty C, et al. The Role of Sex and Gender in Dermatology-From Pathogenesis to Clinical Implications. J Cutan Med Surg. 2023;27(4):NP1-36.
23. Serra MS, Aguinaga F. Skin disorders in transgender patients. in dermatology in public health environments: a comprehensive textbook 2023 Apr 1 (pp. 1405-1411). Cham: Springer International Publishing.
24. Breetzke GD. Crime and spatiality in South African cities. Urban geography in South Africa. Perspectives and theory. 2020:155-72.
25. Enaifoghe A, Dlelana M, Durokifa AA, Dlamini NP. The prevalence of gender-based violence against women in South Africa: A call for action. African Journal of Gender, Society & Development. 2021;10(1):117
26. Al Muqarrab F, Almohssen A. Low‐dose oral isotretinoin for the treatment of adult patients with mild‐to‐moderate acne vulgaris: Systematic review and meta‐analysis. Dermatol Ther. 2022;35(4):e15311.
27. Layton AM, Thiboutot D, Tan J. Reviewing the global burden of acne: how could we improve care to reduce the burden?. Br J Dermatol. 2021;184(2):219-25.
28. Corcoran L, Muller I, Layton AM, et al. Systematic review of clinical practice guidelines for acne vulgaris published between January 2017 and July 2021. Skin Health Dis. 2023;3(4):e240.
29. Davids LM, Van Wyk J, Khumalo NP, Jablonski NG. The phenomenon of skin lightening: Is it right to be light?. South African Journal of Science. 2016;112(11-12):1-5.
30. Lince-Deroche N, Hendrickson C, Moolla A, Kgowedi S, Mulongo M. Provider perspectives on contraceptive service delivery: findings from a qualitative study in Johannesburg, South Africa. BMC Health Serv Res. 2020;20(1):128.
31. Weld ED, Bailey TC, Waitt C. Ethical issues in therapeutic use and research in pregnant and breastfeeding women. Br J Clin Pharmacol. 2022;88(1):7-21.
32. Kocyigit S, Sahin M, Houshyar Y, Dost günay FA, Çorapçioğlu D. Effects of isotretinoin treatment on levels of hormones involved in the etiopathogenesis of acne. Turkish Journal of Endocrinology and Metabolism. 2020;24(3):237-46.
33. Awadhalla F, Jaber M, Alfalasi H, Hallak Y. Rhabdomyolysis in a Physically Active Patient on Isotretinoin Therapy: A Case Report. Case Reports and Reviews. 2024;4(1):1-2.
34. Syed MF, Rehmani A, Yang M. Ocular side effects of common systemic medications and systemic side effects of ocular medications. Med Clin North Am. 2021;105(3):425-44.
35. Kapała J, Lewandowska J, Placek W, Owczarczyk-Saczonek A. Adverse events in isotretinoin therapy: a single-arm meta-analysis. Int J Environ Res Public Health. 2022;19(11):6463.
36. Bunick CG, Teng JM, Guenthner S, et al. Characteristics and outcomes for participants with congenital ichthyosis who responded to treatment with the topical isotretinoin formulation TMB-001: results from the Phase IIb CONTROL study. Clin Exp Dermatol. 2023;48(7):765-9.
37. Jarab AS, Al-Azzam SI, Al-Mutairi S, et al. Community pharmacists’ knowledge and awareness about isotretinoin therapy and its dispensing practice in Jordan. Heliyon. 20231;9(11):e22354.
38. Kruger UV. A retrospective analysis of the prescribing patterns of isotretinoin [dissertation]. South Africa, Potchefstroom: North-West University; 2008.
39. Lugani T, Nagpal M, Malik DS, Sharma A, Puri V, Dhingra GA. Nanocarriers as Prospective Approach in Effective Management of Acne Vulgaris. Micro and Nanosystems. 2021;13(3):253-66.
40. Dabash D, Salahat H, Awawdeh S, et al. Prevalence of acne and its impact on quality of life and practices regarding self-treatment among medical students. Sci Rep. 2024;14(1):4351.
| Files | ||
| Issue | Vol 12, No 4 (Autumn 2024) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/jpc.v12i4.17457 | |
| Keywords | ||
| Isotretinoin South Africa Misuse Controlled Substances Abuse | ||
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How to Cite
1.
Mayimele N. A Review of the Misuse of Isotretinoin in South Africa. J Pharm Care. 2024;12(4):244-249.
