ORIGINAL ARTICLE Evaluation of oral isotretinoin effects on hearing system in patients with acne vulgaris: Reversible or not? Funda Kemeriz 1 | SerkanKayabas¸ı 2 | Bengü Cevirgen Cemil 3 | Ömer Hızlı 4 1 Department of Dermatology, Aksaray University Faculty of Medicine, Aksaray, Turkey 2 Department of Otolaryngology, Aksaray University Faculty of Medicine, Aksaray, Turkey 3 Department of Dermatology, Dıskapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey 4 Department of Otolaryngology, Balıkesir University Faculty of Medicine, Balıkesir, Turkey Correspondence Funda Kemeriz, Department of Dermatology, Aksaray University Faculty of Medicine, 68200 Aksaray, Turkey. Email: dr.fkmrz@hotmail.com Abstract Systemic isotretinoin is commonly used for severe acne treatment. It has many side effects, one of these is about hearing system, which has rarely been reported, also previous studies reported contradictory results about systemic isotretinoin and its association with hearing system. In this study, we aimed to investigate whether sys- temic isotretinoin affected on the hearing system or not. The study included 32 acne vulgaris patients (64 ears) who treated with oral isotretinoin 0.5 mg/kg body weight for at least 4 months and audiometric tests including pure-tone, speech, bilateral acoustic reflexes, and tympanometric measurements were performed at baseline, in the first week, in the first month, and third month of treatment, and sixth month after treatment. Audiometric tests were performed for right and left ears separately. A sig- nificant difference was found in the pure-tone thresholds (before treatment, first week, first month, third month of treatment, and sixth month after treatment) for the both ears at 8000 Hz (P < .001) and a significant decrease in the sixth month post- treatment pure-tone thresholds compared to pre-treatment thresholds at 8000 Hz. Additionally, a statistically significant increase was observed in serum LDL and tri- glyceride levels in the third month of treatment and a significant decrease at the sixth month after treatment (P < .001). Systemic isotretinoin caused bilateral hearing threshold changes in acne patients during the therapy but the changes improved after discontinuation. Therefore, our findings may provide safety using for dermatol- ogists about hearing effects of isotretinoin, which is quite effective on severe acne. KEYWORDS acne, hearing, isotretinoin 1 | INTRODUCTION Systemic isotretinoin, a synthetic derivative of vitamin A (retinol), remains the most efficacious treatment of severe acne. Many cases of more moderate disease, which are unresponsive to other treatment modalities, are treatable with systemic isotretinoin. 1 It is the only ther- apy having impacts on all of the major etiological factors implicated in acne. By influencing various stages of the cell cycle, such as, progres- sion, differentiation, and apoptosis, isotretinoin shows success in treatment. 1-7 It greatly reduces sebum production, influences com- edogenesis, reduces the colonization of Propionibacterium acnes, and has anti-inflammatory properties. 2-5 Various narrative reviews and, studies on acne have discussed the efficacy and adverse events of oral isotretinoin, but studies about the side effects on the hearing system have rarely been reported. 3,8-11 The goal of this prospective study was to investigate whether systemic isotretinoin affects hearing functions with pure-tone audi- ometry, speech audiometry, and tympanometry. Received: 24 October 2020 Revised: 20 November 2020 Accepted: 1 December 2020 DOI: 10.1111/dth.14640 Dermatologic Therapy. 2020;e14640. wileyonlinelibrary.com/journal/dth © 2020 Wiley Periodicals LLC. 1 of 5 https://doi.org/10.1111/dth.14640