Can an Acne Drug (Accutane) Cause Negative Hormone Effects?

[Nelson Vergel]

Young people and men on testosterone and/or anabolic steroids sometimes suffer from acne. Accutane is one of the most commonly prescribed and effective drugs for acne. But there are concerns that it may affect hormones. No one knows how long after drug cessation things normalize, but I have had two men consult with me who saw a significant and permanent drop in blood levels of testosterone after its use.

I take zinc/copper, wash with Nizoral shampoo, get some sun and limit greasy food and that was worked well for me to stop the acne on my back.





These two studies show concerns:

Accutane can affect growth hormone's effect.

Reference:

Short-term isotretinoin (accutane) treatment decreases insulin-like growth factor-1 and insulin-like growth factor binding protein-3 levels: does isotretinoin affect growth hormone physiology? - Karadag - 2010 - British Journal of Dermatology - Wiley Online Library Short-term isotretinoin treatment decreases insulin-like growth factor-1 and insulin-like growth factor binding protein-3 levels: does isotretinoin affect growth hormone physiology? - Karadag - 2010 - British Journal of Dermatology - Wiley Online Lib

Accutane can also affect pituitary hormones (LH, FSH) which affect testosterone levels:

Reference: Isotretinoin Influences Pituitary Hormone Levels in Acne Patients. Authors: Karadag, Ayse Serap; Ertugrul, Derun Taner; Tutal, Emre; Akin, Kadir Okhan Source: Acta Dermato-Venereologica, Volume 91, Number 1, January 2011 , pp. 31-34(4)

 

[Nelson Vergel]

This study contradicts the previous ones on Accutane

The Effect of Systemic Isotretinoin on Male Fertility


BACKGROUND/OBJECTIVE: Acne vulgaris is one of the most common diseases of the youth. Systemic isotretinoin is the only drug which acts on all of the etiopathogenic mechanisms of acne. Isotretinoin has some well-known side effects. Besides these, there is a suspicion whether it causes infertility or not. In this study, we aimed to evaluate the effects of systemic isotretinoin on male fertility.


METHODS: Eighty one male patients, who were older than 18 years of age, and had severe or refractory acne vulgaris were included in the study. They were given a total dose of 120 mg/kg of systemic isotretinoin over a period of six months.


Before and after the study, the spermiogram parameters of the patients were evaluated to show any possible effect on male fertility. The patients' total testosterone, follicle stimulating hormone and luteinizing hormone levels were also evaluated.


RESULTS: All of the spermiogram parameters changed positively (p < 0.05). There was no significant change in the hormone levels.


CONCLUSION: Systemic isotretinoin has a positive effect on male fertility. Since the hormone levels did not change significantly, this positive effect of isotretinoin is not via the hypothalamic-pituitary-gonadal axis but can be due to its regenerative and proliferative effects on the testes.


Cinar L, Kartal D, Ergin C, et al. The effect of systemic isotretinoin on male fertility. Cutan Ocul Toxicol 2015:1-4. http://www.tandfonline.com/doi/full/10.3109/15569527.2015.1119839#abstract