20. ASSESSING THE RELATIONSHIP BETWEEN STRESS LEVEL, SLEEP QUALITY, LIFE QUALITY AND CHANGES IN FSH, LH, PROLACTIN HORMONE CONCENTRATIONS WITH THE RESULTS OF TREATMENT OF SEVERE ACNE VULGARIS WITH ISOTRETINOIN
Main Article Content
Abstract
Objective: Evaluate the relationship between stress level, sleep quality, quality of life and changes in FSH, LH, prolactin hormone levels with the results of treatment of severe acne vulgaris in female patients with isotretinoin.
Research subjects and methods: Clinical trial, prospective, comparing results before and after 3 months of severe acne vulgaris treatment on 45 female patients with isotretinoin 20 mg/day at the National Dermatology Hospital from October 2022 to September 2023.
Results: After 3 months of treatment, DASS21 score decreased from 13±12 to 11±12, P<0.01; PSQI score decreased from 5.36±3.17 to 4.71±1.84, P=0,04; DSQI score decreased from 7±5 to 4.64±2.6, P<0.01. There is a moderate positive relationship between stress level (r=0.48; P<0.01) and quality of life (r=0.34; P<0.01) with treatment results. There is no relationship between sleep quality and changes in FSH, LH, prolactin levels and treatment results.
Conclusion: Taking isotretinoin 20 mg/day helps reduce stress levels, improve sleep quality, and improve quality of life for female patients with severe acne vulgaris after 3 months of treatment.
Article Details
Keywords
Acne, hormones, isotretinoin, quality of life, quality of sleep, stress.
References
Vulgaris. In: StatPearls [Internet]. StatPearls
Publishing; 2023. Accessed October 29,
2023. https://www.ncbi.nlm.nih.gov/books/
NBK459173160
[2] Bhate K, Williams HC, Epidemiology of acne
vulgaris. Br J Dermatol. 2013;168(3):474-485.
doi:10.1111/bjd.12149
[3] Ding RL, Zheng Y, Bu J, Physiological and
Psychological Effects of Isotretinoin in the
Treatment of Patients with Acne: A Narrative
Review. Clin Cosmet Investig Dermatol.
2023;16:1843-1854. doi:10.2147/CCID.
S416267
[4] Rasi A, Behrangi E, Rohaninasab M et al.,
Efficacy of fixed daily 20 mg of isotretinoin
in moderate to severe scar prone acne. Adv
Biomed Res. 2014;3:103. doi:10.4103/2277-
9175.129693
[5] Lai JJ, Chang P, Lai KP et al., The Role of
Androgen and Androgen Receptor in the Skin
Related Disorders. Archives of dermatological
research. 2012;304(7):499. doi:10.1007/s00403-
012-1265
[6] Angioni AR, Lania A, Cattaneo A et al., Effects
of chronic retinoid administration on pituitary
function. J Endocrinol Invest. 2005;28(11):961-
964. doi:10.1007/BF03345332
[7] Karadag AS, Ertugrul DT, Tutal E et al.,
Isotretinoin influences pituitary hormone
levels in acne patients. Acta Derm Venereol.
2011;91(1):31-34. doi:10.2340/00015555-1013
[8] Karadag AS, Takci Z, Ertugrul DT et al., The
effect of different doses of isotretinoin on pituitary
hormones. Dermatology. 2015;230(4):354-359.
doi:10.1159/000375370
[9] Feily A, Namazi MR, Decrease of insulin growth
factor-1 as a novel mechanism for anti-androgen
effect of isotretinoin and its reported association
with depression in some cases. J Drugs Dermatol.
2011;10(7):793-794
[10] Öztürk S, Öztürk T, Ucak H et al., Evaluation of
ovarian reserve and function in female patients
treated with oral isotretinoin for severe acne:
an exploratory study. Cutan Ocul Toxicol.
2015;34(1):21-24. doi:10.3109/15569527.2014.
888079
[11] Secrest AM, Hopkins ZH, Frost ZE et al.,
Quality of Life Assessed Using Skindex-16
Scores Among Patients With Acne Receiving
Isotretinoin Treatment. JAMA Dermatol.
2020;156(10):1098-1106. doi:10.1001/
jamadermatol.2020.2330
[12] Fakour Y, Noormohammadpour P, Ameri H
et al., The Effect of Isotretinoin (Roaccutane)
Therapy on Depression and Quality of Life of
Patients with Severe Acne. Iran J Psychiatry.
2014;9(4):237-240.
[13] Kapała J, Lewandowska J, Placek W et al.,
Adverse Events in Isotretinoin Therapy: A
Single-Arm Meta-Analysis. Int J Environ Res
Public Health. 2022;19(11):6463. doi:10.3390/
ijerph19116463
[14] Doshi A, Zaheer A, Stiller MJ, A comparison of
current acne grading systems and proposal of a
novel system. Int J Dermatol. 1997; 36(6):416-
418. doi:10.1046/j.1365-4362.1997.00099.x
[15] Kariya M, kandre D, Patel A, Prevalence of
stress, anxiety and depression in patients of
Acne vulgaris. IP Indian Journal of Clinical and
Experimental Dermatology. 2020;6:243-248.
doi:10.18231/j.ijced.2020.049
[16] Schrom KP, Ahsanuddin S, Baechtold M et
al., Acne Severity and Sleep Quality in Adults.
Clocks Sleep. 2019;1(4):510-516. doi:10.3390/
clockssleep1040039
[17] Wang X ling, Zhao T en, Zhang X qin, Assessment
on the reliability and validity of the Dermatology
Life Quality Index in Chinese version. Zhonghua
Liu Xing Bing Xue Za Zhi. 2004;25(9):791-793
[18] Rasmussen JE, Smith SB, Patient concepts and
misconceptions about acne. Arch Dermatol.
1983;119(7):570-572
[19] Zari S, Alrahmani D, The association between
stress and acne among female medical students
in Jeddah, Saudi Arabia. Clin Cosmet Investig
Dermatol. 2017;10:503-506. doi:10.2147/CCID.
S148499
[20] Ozlu E, Ertaş R, Özyurt K et al., Effects of
Isotretinoin Treatment on Sleep and Quality of
Life in Patients with Acne Vulgaris. Konuralp161
Tıp Dergisi. 2018;10:65-73. doi:10.18521/
ktd.378682
[21] Kridin K, Ludwig RJ, Reply to comment
on: “Isotretinoin and the risk of psychiatric
disturbances - A global study shedding
new light on a debatable story.” J Am Acad
Dermatol. 2023;89(5):e251-e252. doi:10.1016/j.
jaad.2023.04.049
[22] Shabnam, A Study on Prevalence of Acne
Vulgaris and Its Impact on Quality of Life
in Adolescents of Kendriya Vidyalaya’s of
Jalahalli Area of Bangalore. Int J Health Sci Res.
2021;11(9):33-40. doi:10.52403/ijhsr.20210905
[23] Huei LT, Prevalence and psychosocial impact of
acne vulgaris among high school and university
students in Sarawak, Malaysia. 2022;77(4).
[24] Ianoşi S, Ianoşi G, Neagoe D et al., Age
dependent endocrine disorders involved in the
pathogenesis of refractory acne in women. Mol
Med Rep. 2016;14(6):5501-5506. doi:10.3892/
mmr.2016.5924