Acne Medication May Raise Risk of Eye Infections

THURSDAY, May 31 (HealthDay News) — Teens who take the acne
medication commonly known as Accutane (isotretinoin) appear to face twice
the risk of eye infections, including conjunctivitis (pink eye) and styes,
a new study says.

Researchers in Israel collected data on nearly 15,000 teens and young
adults taking isotretinoin to treat acne and compared their rates of eye
infections to an age- and gender-matched group that had acne but was not
taking the drugs and to a third group that didn’t take the drugs and
didn’t have acne. Isotretinoin is also sold under the brand names
Roaccutane, Amnesteem, Claravis, Myorisan and Sotret.

Within a year of starting the medication, nearly 14 percent of those in
the acne medication group developed an eye infection or dry eyes, compared
with almost 10 percent in the group that had acne but did not take the
medications and about 7 percent in the group that didn’t have acne.

Compared to the acne-free group, those taking isotretinoin were at 70
percent increased risk of an eye infection over the course of a year. The
mean age of participants was about 16.5 years old.

The most common problem was conjunctivitis, an inflammation or
infection of the membrane lining the eyelids. About 4 percent of teens
taking isotretinoin developed conjunctivitis, compared with 2 percent of
those without acne and not taking the medication.

Other problems included hordeolum (or stye, an inflamed oil gland on
the edge of the eyelid); chalazion (a tender, swollen lump in the eyelid
due to a blocked oil gland); blepharitis (inflammation of the eyelash
follicles), dry eyes or eye pain, the researchers said.

Isotretinoin treats acne by reducing oil production from the sebaceous
glands, among other effects. But isotretinoin also disrupts function of
the meibomian glands, or oil glands inside the eyelids, explained study
co-author Gabriel Chodick, head of the epidemiology and database research
unit at Maccabi Institute for Healthcare Services Research in Tel Aviv,
Israel.

The meibomian glands help keep the eyes lubricated. Less lubrication
may mean the eyes are irritated, itching and burning, prompting people to
rub them and introduce bacteria. It’s also possible that less lubrication
makes it easier for bacteria to take hold, said Dr. Jonette Keri, an
associate professor of dermatology and cutaneous surgery at the University
of Miami Miller School of Medicine.

The good news is that most side effects of the drugs can be prevented
using artificial tears to keep the eyes lubricated, experts said.

“In case of any meaningful side effect, such as significant eye
irritation, itching, redness, pain, tearing, excessive tearing, patients
are advised to consult with their physician before making any decisions
regarding therapy discontinuation,” Chodick said.

The study was published recently in the Archives of
Dermatology
.

Keri said vision side effects from acne medications are well known to
most dermatologists. She tells patients who wear contacts and are starting
the medications to use eye drops to combat dry eyes, but that they may
have to discontinue wearing contacts while they’re on the drug if that
doesn’t help enough.

“What’s interesting is that the researchers found eye problems
associated with the drugs peak at about four months after starting the
medication, so I’m going to tell my patients to really watch their eyes
around month four,” she added.

Patients usually take isotretinoin for about five to eight months, she
noted.

More information

The U.S National Library of Medicine has more on isotretinoin.

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