{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T18:04:56Z","timestamp":1786125896623,"version":"build-2736575974"},"reference-count":26,"publisher":"Mattioli1885","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Introduction: Systemic isotretinoin is extensively used to treat moderate-to-severe acne vulgaris and may have systemic endocrine effects through the hypothalamic-pituitary-thyroid axis. Objectives: To investigate the changes in thyroid hormone levels after commencement of systemic isotretinoin among patients with acne vulgaris. Methods: A PubMed, ScienceDirect, Scopus, and Cochrane Library search was performed. Pooled analysis was conducted utilizing Review Manager (RevMan 5.4.1). Results: A total of 447 patients from eight observational studies were included. After three and four months, no increase in TSH levels was observed following isotretinoin treatment with a standardized mean difference (SMD) of 0.09 (95% CI: -0.27\u20130.46; P=0.62) and (SMD=0.72; 95% CI: -0.01\u20131.45; P&gt;0.05), respectively. However, a significant increase in TSH levels was observed at six months (SMD=0.54; 95% CI: 0.05\u20131.03; P=0.03). T4 levels showed no alteration at three months (SMD= \u22120.24; 95% CI: -0.56\u20130.08; P=0.14) but were reduced at four months (SMD= -0.79; 95% CI: -1.20\u2013 -0.38; P=0.0001) and six months (SMD= -0.87; 95% CI: -1.57\u2013 -0.17; P=0.01). T3 levels were reduced at three months (SMD= -0.42; 95% CI: -0.80\u2013 -0.04; P=0.03), four months (SMD= -0.63; 95% CI: -1.03\u2013 -0.23; P=0.002), and 6 months (SMD= -1.13; 95% CI: -1.77\u2013 -0.55; P=0.0001). Conclusion: Long-term isotretinoin treatment may cause time-dependent changes in thyroid hormone levels.<\/jats:p>","DOI":"10.5826\/dpc.1603a7403","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T15:08:41Z","timestamp":1785510521000},"page":"7403","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Isotretinoin Therapy on Thyroid Hormone Levels in Patients with Acne Vulgaris: A Systematic Review and Meta-Analysis"],"prefix":"10.5826","volume":"16","author":[{"given":"Mishari Tariq","family":"Alrubaiaan","sequence":"first","affiliation":[{"name":"College of Medicine, King Saud Bin Abdulaziz University for Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajlan Hashim","family":"Alajlani","sequence":"additional","affiliation":[{"name":"College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raneem","family":"Alwatban","sequence":"additional","affiliation":[{"name":"College Of Medicine, King Saud University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulelah Nabil","family":"Alkadi","sequence":"additional","affiliation":[{"name":"College of Medicine, King Faisal University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hawra Fahad","family":"Alkhodairy","sequence":"additional","affiliation":[{"name":"College Of Medicine, King Saud bin Abdulaziz University for Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatimah Moayed","family":"Alalwan","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah Waleed","family":"Bin Rashid","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud Bin Abdulaziz University for Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waleed","family":"Alajroush","sequence":"additional","affiliation":[{"name":"Medical Degree - Department of Pediatric Dermatology, King Abdulaziz Medical City"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"27750","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"10.5826\/dpc.1603a7403_ref1","doi-asserted-by":"crossref","unstructured":"Salem Hareedy M, Mahmoud WA, Tawfik KM. Patterns of thyroid dysfunctions in adolescent patients suffering from severe acne during isotretinoin treatment. Clin Exp Pharmacol Physiol. 2021;48(10):1317-1326. DOI:10.1111\/1440-1681.13552.","DOI":"10.1111\/1440-1681.13552"},{"key":"10.5826\/dpc.1603a7403_ref2","doi-asserted-by":"crossref","unstructured":"Rygu\u0142a I, Pikiewicz W, Kamini\u00f3w K. Impact of Diet and Nutrition in Patients with Acne Vulgaris. Nutrients. 2024;16(10):1476. Published 2024 May 14. DOI:10.3390\/nu16101476.","DOI":"10.3390\/nu16101476"},{"key":"10.5826\/dpc.1603a7403_ref3","doi-asserted-by":"crossref","unstructured":"Eichenfield DZ, Sprague J, Eichenfield LF. Management of Acne Vulgaris: A Review. JAMA. 2021;326(20):2055-2067. DOI:10.1001\/jama.2021.17633.","DOI":"10.1001\/jama.2021.17633"},{"key":"10.5826\/dpc.1603a7403_ref4","doi-asserted-by":"crossref","unstructured":"Kotb MA, Bin Dayel S, Abahussein O, Hussein RS. 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