Ocular Surveillance During Off-Label Oral Isotretinoin for Photoaging: A Review of Risks and Monitoring...

Low-dose oral isotretinoin is increasingly used off-label for photoaging, with evidence of clinical and histologic skin improvement.

To review ocular risks associated with isotretinoin in aesthetic use and propose monitoring recommendations.

A narrative review of clinical studies, observational data, and mechanistic reports addressing isotretinoin-induced ocular effects was performed, integrating dermatologic and ophthalmologic perspectives.

Reported adverse effects include dry eye disease, meibomian gland dysfunction, and, rarely, retinal alterations. Risk may be cumulative in long-term or repeated cosmetic regimens.

A risk-adapted monitoring approach, emphasizing patient selection, informed consent, and interdisciplinary care, is recommended to balance cosmetic benefits with ocular safety.