Facial Hirsutism as Side Effect of Oral Retinoids Among Females

Authors

  • Saima Rahman Saidu Group of Teaching Hospitals, Saidu Sharif, Swat KP Pakistan
  • Nisar Uddin Saidu Group of Teaching Hospital, Swat, KP Pakistan.
  • Zia Ul Haq Gaju Khan Medical College, Swabi, Pakistan
  • Nadia Sultan Saidu Group of Teaching Hospital, Swat, KP Pakistan.
  • Tabassum Imran Saidu Group of Teaching Hospital, Swat, KP Pakistan.

DOI:

https://doi.org/10.52206/jsmc.2024.14.3.841

Abstract

Background: Oral retinoids remain the most effective treatment for severe acne which is a multifactorial chronic skin disease causing extreme reduction in quality of life. Retinoids long list of side effects includes xerosis, cheilitis, photosensitivity & pigmentation. Data regarding the relationship between retinoids & facial hair is scarce. The relationship needs to be identified & addressed as facial hair again is cause of decrease in quality of life.
Objective: To determine the facial hirsutism as a side effect of oral retinoids among females.
Materials and Methods: Data for the study was collected from 300 female patients visiting Dermatology OPD of Saidu Group of Taching Hospitals, Swat, during the year 2020. Demographic data was collected from the patients. Patients with severe acne were included in the study and they were put on oral retinoids 0.5mg/kg day for four whole months. The rationale was to understand the prevalence of appearance of facial hair in these patients as new entity.
Results: The study was completed by 300 female patients having severe acne and were started by oral retinoids and follow ups made monthly for 4 months. The results of the study show that facial hair appearance was highest (43.43%) in age group 30-35 years and lowest (3.03%) in age group, 36-41%. Of total 300, 99 (33%) got facial hirsutism and 201 (67%) had no facial hair.
Conclusion: This study highlights facial hirsutism as a significant and frequently observed side effect among 33% of 300 female patients on oral retinoids for severe acne, while other adverse effects were well tolerated without requiring treatment discontinuation. Further research is essential to explore hirsutism in larger patient cohorts.
Keywords: Acne Vulgaris, Hirsutism, Retinoids

References

Eichenfield DZ, Sprague J, Eichenfield LF. Management of acne vulgaris: a review. Jama. 2021;326(20):2055-67 DOI: https://doi.org/10.1001/jama.2021.17633

Saurat J, Reygagne P, Josse G, Hamidou Z, Bianovici S, Ramel F, et al. Long-Term Use of Silybum marianum fruit extract Contributes to Homeostasis in Acne-Prone SkinA 12-Month Follow-Up International “Real Life” Cohort Study. Journal of Personalized Medicine 2022;13(1) DOI: https://doi.org/10.3390/jpm13010096

Otlewska A, Baran W, Batycka-Baran A. Adverse events related to topical drug treatments for acne vulgaris. Expert Opinion on Drug Safety. 2020;19(4):513-21 DOI: https://doi.org/10.1080/14740338.2020.1757646

Bettoli V, Guerra-Tapia A, Herane MI, Piquero-Martín J. Challenges and solutions in oral isotretinoin in acne: reflections on 35 years of experience. Clinical, cosmetic and investigational dermatology. 2019:943-51 DOI: https://doi.org/10.2147/CCID.S234231

Chu S, Michelle L, Ekelem C, Sung CT, Rojek N, Mesinkovska NA. Oral isotretinoin for the treatment of dermatologic conditions other than acne: a systematic review and discussion of future directions. Archives of dermatological research. 2021;313:391-430 DOI: https://doi.org/10.1007/s00403-020-02152-4

Reynolds RV, Yeung H, Cheng CE, Cook-Bolden F, Desai SR, Druby KM, et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. 2024. DOI: https://doi.org/10.1016/j.jaad.2023.12.017

Tan SY, Chandran NS, Choi EC-E. Steroid phobia: is there a basis? A review of topical steroid safety, addiction and withdrawal. Clinical Drug Investigation. 2021;41:835-42 DOI: https://doi.org/10.1007/s40261-021-01072-z

Callender VD, Baldwin H, Cook-Bolden FE, Alexis AF, Stein Gold L, Guenin E. Effects of topical retinoids on acne and post-inflammatory hyperpigmentation in patients with skin of color: a clinical review and implications for practice. American journal of clinical dermatology. 2022;23(1):69-81 DOI: https://doi.org/10.1007/s40257-021-00643-2

Al-Saeedi F RP. 13-cis-Retinoic Acid Affects Brain Perfusion and Function: In Vivo Study. Molecular Imaging. 2023 DOI: https://doi.org/10.1155/2023/7855924

Tewary S, Davies R, Prakash A. Hirsutism. Obstetrics, Gynaecology & Reproductive Medicine. 2021;31(4):103-8 DOI: https://doi.org/10.1016/j.ogrm.2021.02.004

Brtko J, Dvorak Z. Natural and synthetic retinoid X receptor ligands and their role in selected nuclear receptor action. Biochimie. 2020;179:157-68 DOI: https://doi.org/10.1016/j.biochi.2020.09.027

Lumezi B, Berisha V, Pupovci H, Goçi A, Hajrushi A. Grading of hirsutism based on the Ferriman- Gallwey scoring system in Kosovar women. Advances in Dermatology and Allergology/Postêpy Dermatologii i Alergologii. 2018;35(6):631-5 DOI: https://doi.org/10.5114/ada.2018.77615

Campero-Basaldua C H-GJ, Bernal-Ramírez J, Lopez-Moran S, Luévano-Martínez LA, Alves-Figueiredo H, Guerrero G, et al. The retinoic acid response is a minor component of the cardiac phenotype in H9c2 myoblast differentiation. BMC Genomics. 2023;24(1):431 DOI: https://doi.org/10.1186/s12864-023-09512-0

Zhang P, Tian L, Bao J, Li S, Li A, Wen Y, et al. Isotretinoin impairs the secretory function of meibomian gland via the PPARã signaling pathway. Investigative Ophthalmology & Visual Science. 2022;63(3):29-33. DOI: https://doi.org/10.1167/iovs.63.3.29

Aktar R, Gunes Bilgili S, Yavuz IH, Ozaydin Yavuz G, Aktar S, Ozturk M, et al. Evaluation of hirsutism and hormonal parameters in acne vulgaris patients treated with isotretinoin. International Journal of Clinical Practice. 2021;75(3):e13791 DOI: https://doi.org/10.1111/ijcp.13791

Gkini M-A, Joliffe V. Hair disorders and impact on quality of life. Psychodermatology in Clinical Practice: Springer; 2021. p. 283-302.

Brzezinski P, Andruszkiewicz J, Sinjab A, Chiriac A. Recurrent basal cell carcinoma in patient treated by cryotherapy. Journal of Pakistan Association of Dermatologists 2013;23(4):436-9. 2013;23(4):436-9.

Spritzer PM, Marchesan LB, Santos BR, Fighera TM. Hirsutism, normal androgens and diagnosis of PCOS. Diagnostics. 2022;12(8):1922 DOI: https://doi.org/10.3390/diagnostics12081922

Ramírez-Marín HA, Tosti A. Emerging drugs for the treatment of alopecia areata. Expert opinion on emerging drugs. 2022;27(4):379-87 DOI: https://doi.org/10.1080/14728214.2022.2149735

GÜNEª M. Evaluation of Hirsutism in Premenopausal Women. Current Research in General Internal Medicine. 2023:11.

Everts H. Endogenous retinoids in the hair follicle and sebaceous gland. Biochimica et Biophysica Acta (BBA)-Molecular and Cell Biology of Lipids. 2012;1821(1):222-9 DOI: https://doi.org/10.1016/j.bbalip.2011.08.017

Dawber R, Rundegren J. Hypertrichosis in females applying minoxidil topical solution and in normal controls. J Eur Acad Dermatol Venereol 2003;17:271-5 DOI: https://doi.org/0.1046/j.1468-3083.2003.00621.x

Zhou J, Li X, Chen H, Qi Z, Shao S, Tang Y, et al. Effects and safety of acne vulgaris with external application of herbal medicines: a protocol for systematic review and meta analysis. Medicine. 2021;100(26):e26408 DOI: https://doi.org/10.1097/MD.0000000000026408

Unluhizarci K, Karaca Z, Kelestimur F. Role of insulin and insulin resistance in androgen excess disorders. World journal of diabetes. 2021;12(5):616 DOI: https://doi.org/10.4239/wjd.v12.i5.616

Additional Files

Published

24-07-2024

How to Cite

1.
Saima Rahman, Nisar Uddin, Zia Ul Haq, Nadia Sultan, Tabassum Imran. Facial Hirsutism as Side Effect of Oral Retinoids Among Females. J Saidu Med Coll Swat [Internet]. 2024 Jul. 24 [cited 2024 Nov. 6];14(3):155-60. Available from: https://jsmc.pk/index.php/jsmc/article/view/841