#Acne Treatment: the combination of isotretinoin (Accutane) with antihistamine improves the results and reduces side-effects.

Isotretinoin remains the gold standard in the treatment of Acne Vulgaris especially because nowadays we focus on lower and more tolerable doses. However, even so, patients can have difficulties to tolerate it because of the occurrence of side effects such as xerosis (very dry skin and mucousae). Besides, isotretinoin can have adverse effects on liver function and lipid metabolism.

To avoid this, researchers studied forty patients, 20 taking oral isotretinoin alone, and 20 with additional desloratadine (antihistamine, selective anti-H1 receptor antagonist). Results show that after 20 weeks of treatment, patients taking isotretinoin + antihistamine had a significant decrease in acne lesions counts, sebum and erythema. Also the occurrence of flare-ups was significantly reduced: it was described in only one subject taking the combined therapy (vs. 6 in the isotretinoin treated group). 

Comment: the beneficial effects of anthistamines (here desloratine) seem too be warranted in the treatment of severe acne with isotretinoin. The lack of long term follow-up limits the scope of this study.