Heppt Markus V, Kirchberger Michael C, Ruzicka Thomas, Berking Carola, Heppt Werner J
Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany.
Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany.
Facial Plast Surg. 2018 Feb;34(1):75-81. doi: 10.1055/s-0037-1617446. Epub 2018 Feb 6.
Isotretinoin is a first generation retinoid with pleiotropic effects on keratinocyte differentiation, proliferation, and activity of sebaceous glands. For years, there has been intense debate on whether the use of isotretinoin combined with cosmetic or surgical procedures is safe and potentially more efficient than either therapy alone. Due to delays in wound healing and keloid formation, conservative recommendations were not to combine isotretinoin with any plastic surgery or local treatment at 6 to 12 months after discontinuation of the drug. However, there is increasing evidence that a combination approach is not only safe, but may also provide excellent cosmetic outcomes in acne scars, sebaceous gland hyperplasia, and thick-skinned patients undergoing facial plastic surgery. In particular, low-dose regimens of isotretinoin may offer advantages over standard dosage treatments because of better tolerability and safety in long-term use adjunct with surgical interventions. In this article, the authors aim to summarize the current evidence on the use of isotretinoin in facial plastic surgery and to share their experience from selected patients.
异维A酸是第一代维甲酸，对角质形成细胞的分化、增殖以及皮脂腺的活性具有多效性作用。多年来，关于异维A酸与美容或外科手术联合使用是否安全以及是否可能比单独使用任何一种治疗方法更有效，一直存在激烈的争论。由于伤口愈合延迟和瘢痕疙瘩形成，保守的建议是在停药后6至12个月内不要将异维A酸与任何整形手术或局部治疗联合使用。然而，越来越多的证据表明，联合治疗方法不仅安全，而且对于痤疮瘢痕、皮脂腺增生以及接受面部整形手术的厚皮患者，可能还能带来出色的美容效果。特别是，异维A酸的低剂量方案可能比标准剂量治疗更具优势，因为在与手术干预联合长期使用时具有更好的耐受性和安全性。在本文中，作者旨在总结目前关于异维A酸在面部整形手术中应用的证据，并分享他们从部分患者身上获得的经验。
