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Related Experiment Video

Updated: Sep 8, 2025

Author Spotlight: Development and Evaluation of a Compound Acne Rodent Model Using C. acnes and Oleic Acid
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Isotretinoin Laboratory Monitoring in Acne Treatment: A Delphi Consensus Study.

Eric Xia1,2, Jane Han1,3, Adam Faletsky1,4

  • 1Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

JAMA Dermatology
|June 15, 2022
PubMed

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Summary

Experts established consensus on isotretinoin monitoring, recommending alanine aminotransferase and triglyceride checks before and during treatment. Routine monitoring of complete blood counts and other metabolic panels is not advised for isotretinoin therapy.

Area of Science:

  • Dermatology
  • Clinical Pharmacology
  • Medical Practice Guidelines

Background:

  • Isotretinoin, a common acne treatment, can cause rare laboratory abnormalities like hypertriglyceridemia.
  • Current clinical practice for monitoring isotretinoin therapy varies widely, lacking established consensus.

Purpose of the Study:

  • To establish an international expert consensus on optimal laboratory monitoring during isotretinoin treatment for acne.
  • To provide evidence-based recommendations for laboratory testing protocols in patients receiving isotretinoin.

Main Methods:

  • A modified electronic Delphi process involving 4 rounds of anonymous surveys was employed.
  • International board-certified dermatologists with expertise in acne participated voluntarily.
  • Consensus was defined as ≥70% agreement on specific laboratory monitoring parameters and timing.

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Main Results:

  • Consensus was reached to check alanine aminotransferase and triglycerides within one month prior to isotretinoin initiation and at peak dose.
  • Experts agreed against routine monthly monitoring or post-treatment checks for these parameters.
  • Consensus was also achieved to not monitor complete blood cell counts, basic metabolic panels, gamma-glutamyl transferase, bilirubin, albumin, total protein, LDL, HDL, or CRP during isotretinoin therapy.

Conclusions:

  • This Delphi study defined a core set of essential laboratory tests for isotretinoin monitoring.
  • The findings offer valuable guidance for clinical practice and the development of standardized clinical guidelines for isotretinoin therapy.