The effect of isotretinoin treatment for acne vulgaris on height in adolescents: A retrospective cohort study using the Rochester Epidemiology Project.

Abstract

Isotretinoin is the first-line treatment for severe acne, but its effects on adolescent growth remain unclear. To assess the effects of isotretinoin on final adult height and height velocity in adolescents treated for acne. This retrospective cohort study used the Rochester Epidemiology Project to identify patients diagnosed with acne between 2005 and 2021 who initiated isotretinoin or oral antibiotics before age 15. Height velocity was calculated using measurements taken within 1 year pre- and postmedication initiation, and final height was recorded at 18 years. Multivariable regression models adjusted for age and sex. Among 226 patients treated with isotretinoin and 1179 controls, final height did not differ significantly between groups (-0.67 cm; CI: -2.21 to 0.87). However, patients treated with isotretinoin had a lower postmedication initiation height velocity (-0.12 cm/month; CI: -0.21 to -0.04, P = .005) and a greater reduction in post- versus premedication initiation height velocity (-0.31 cm/month; CI: -0.54 to -0.07, P = .011). No significant dosage effects were observed. The study was limited by sample size, potential unmeasured confounders, and a predominantly non-Hispanic white population. While isotretinoin may reduce height velocity, it is not associated with negative effects on final adult height among adolescents treated for acne.