Moreover, the positive effect of systemic isotretinoin in the treatment of cutaneous photoaging has been reported in recent years. Topical retinoids are largely used in the treatment, as well as the prevention, of cutaneous photoaging, and their efficacy is well established ,. The patient stated that she had maintained strict avoidance of ultraviolet light exposure prior to her CP procedure as well as in the postpeel period. She had not used oral contraception, estrogens or other photosensitizing agents. It must be noted that the patient had initiated the isotretinoin treatment on her own behalf without consulting her dermatologist. Systemic isotretinoin was discontinued 3 weeks prior to her last session of CP. At the initial referral, persistent questioning revealed a history of treatment with 10 mg of isotretinoin three times per week because of a coarse-pored skin for the preceding 10 weeks. During the postpeel period, bland emollients as well as sunscreens had been applied. Prepeel preparations had been performed with 8% glycolic acid. ![]() According to her medical history, she had received repetitive treatments with 70% glycolic acid without any discomfort or complications for the past several months. She reported that a facial 70% glycolic acid peel had been performed 3 days prior to her examination at our clinic. Her initial physical examination revealed isolated erosions of her forehead (Figure 1B). There is a potential risk of hyperpigmentation and scarring with the use of a combination of low-dose oral isotretinoin and glycolic acid peeling.Ī 34-year-old woman presented to our department with severe, painful erythema and hyperpigmentation of her face and neck (Figure 1). ![]() ![]() In this report, we present the case of a patient receiving low-dose oral isotretinoin therapy who developed severe painful erythema and erosions that led to permanent hyperpigmentation and scarring of her face and neck after undergoing superficial CP with glycolic acid. Even though the combination of systemic isotretinoin and medium to deep CP has been associated with serious side effects such as delayed wound healing and enlarged incidence of scarring, to date superficial CP and concomitant systemic isotretinoin have been considered safe. In addition, well-recognized topical antiaging therapies such as superficial chemical peeling (CP) with α-hydroxy acids have been shown to be more helpful when combined with low-dose oral isotretinoin. The application of systemic isotretinoin in the treatment of cutaneous photoaging has been well investigated.
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