Oral Isotretinoin with Desloratadine Compared with Oral Isotretinoin Alone in the Treatment of Moderate to Severe Acne: A Mini Review

Background: Acne vulgaris, a common dermatological condition, often requires effective and well-tolerated treatment strategies, particularly in moderate cases. Oral isotretinoin is a widely used and potent treatment, but its use can be limited by significant side effects, including pruritus and acne flare-ups. Recent studies have explored the potential benefits of combining isotretinoin with antihistamines like desloratadine to enhance therapeutic outcomes and reduce adverse effects.

Methodology: This mini-review evaluates the efficacy of oral isotretinoin combined with desloratadine compared to oral isotretinoin alone for the treatment of moderate to severe acne. A comprehensive literature search was conducted from February 2014 to July 2024 using PubMed, MEDLINE, ScienceDirect, and CINAHL databases. The MeSH terms ‘oral isotretinoin,’ ‘desloratadine,’ ‘acne treatment,’ ‘moderate to severe acne,’ and ‘efficacy’ were employed to retrieve relevant studies. From an initial pool of 854 articles, 742 unique records remained after removing duplicates. After title and abstract screening, 712 studies were excluded, leaving 30 articles for full-text review. A further 24 studies were excluded due to inapplicable outcomes or study design, resulting in six papers being included in the final review.

Results: The selected studies indicated that combining oral isotretinoin with desloratadine significantly improved treatment outcomes compared to isotretinoin alone. Patients receiving the combination therapy demonstrated a higher curative rate, fewer inflammatory lesions, and lower Global Acne Grading System (GAGS) scores. Additionally, the combination therapy resulted in fewer side effects, such as pruritus, enhancing patient satisfaction.

Conclusion: Combining oral isotretinoin with desloratadine appears to be a superior treatment strategy for moderate acne vulgaris, offering both enhanced efficacy and reduced side effects compared to isotretinoin alone. This synergistic approach may represent an optimal treatment paradigm for patients with moderate acne vulgaris.