1. DR ANUP KUMAR LAHIRY MD;DD
CONSULTANT DERMATOLOGIST
SKIN AND LASER CLINIC
HYDERABAD

2. ISOTRETINOIN AND ABLATIVE PROCEDURES

3. THE FEAR:
WORSENING OF HYPERTROPHIC SCARS AND KELOIDS AFTER DERMABRASION AND DISTURBANCE IN HEALING PROCESS WAS REPORTED BETWEEN ,IN PATIENTS WHO WERE ON ISOTRETINOIN BEFORE OR DURING THE PROCEDURE.

4. Reports
Early chemabrasion for acne scar after treatment with oral isotretinoin.
Dermatol surg;2012 sep,38(9):1521-6
- NO ADVERSE AFFECT.
Dermabrasion for Acne scars during treatment with oral isotretinoin.
Dermatol surg;2010 apr;36(4):483-9.
-NORMAL WOUND HEALING-suggested re evaluating 6 months wait for scar revision.
Does systemic Isotroin inhibit healing in porcine wound model?
Aesthet surg J,2012 nov;32(8):
Invasive surgery might be safely performed even in the presence of recent isotretinoin therapy

5. FEW CASES WHO WERE ON ISOTRETINOIN,DURING OR BEFORE THE ABLATIVE PROCEDURES ,WERE FOLLOWED UP FOR MORE THAN 6 MONTHS IN THIS CASE SERIES REPORT.

6. Dermabrasion

7. Post Dermabrasion-8 months

8. Co2 laser ablation-Ultrapulse mode

9. 9 Months Post laser

10. 1 year after AFP

11. 1 yr AFTER AFP

12. CROSS TECHNIQUE:
BEFORE
AFTER 1 ½ YRS

13. PATIENT
CONDITION
KELOID-Y/N
PROCEDURE
FOLLOW UP
OBSERVATION
25 yrs male
Post acne scarring
Keloids+
Dermabrasion
8 months
NO ADVERSE
23 yrs male No
Co2 ablation
9 months
25 female
AFP + Microdermabrasion
1 yr
27 male
AFP+ chemical peel
> 1yr
NO ADVERS
CROSS tech
1 ½ yrs
?DELAY

14. REASON: Idiosyncratic or individual response to Isotretinoin.
Other risk factors-Genetic, Ethnicity and Anatomic area.

15. CONCLUSION
Cumulative data needed to confirm or disprove the side effect.
A metabolite of isotretinoin-4-OXO-ISOTRETINOIN IS FOUND IN BLOOD FOR 2 WEEKS, so any ablative procedure if needed could be done after a month.

16. Thank you