Fear of isotretinoin in moderate-to-severe acne: clinical impact and a new assessment approach
Archives of Dermatological Research, cilt.318, sa.1, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 318 Sayı: 1
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s00403-026-04905-z
- Dergi Adı: Archives of Dermatological Research
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest)
- Anahtar Kelimeler: Isotretinoin, Phobia, Acne, Quality of life
- Uşak Üniversitesi Adresli: Evet
Özet
Systemic isotretinoin is an effective treatment for moderate-to-severe acne vulgaris; however, concerns about adverse effects often cause treatment refusal or poor adherence. The phenomenon of “isotretinoin phobia” is underexplored in terms of prevalence and clinical impact. This study aimed to determine the prevalence of isotretinoin phobia, its associated factors, and its impact on treatment behavior and quality of life using a newly developed Isotretinoin Phobia Scale. This cross-sectional study was conducted between June and December 2025 at Uşak University with 312 patients diagnosed with moderate-to-severe acne vulgaris. Data were collected through a five-part questionnaire, including the 11-item Isotretinoin Phobia Scale (Cronbach’s alpha = 0.86). Statistical analyses comprised descriptive statistics, ROC analysis, Chi-square tests, correlation analyses, and logistic regression to identify predictors of clinically significant phobia (score > 21.5). Of the 312 patients (mean age 20.16 ± 3.96 years), 45.2% had low, 50.3% moderate, and 4.5% high phobia scores. The cut-off for significant phobia was > 21.5 (AUC = 0.806). Higher education correlated positively with phobia scores (ρ = 0.191, p < 0.001). Previous isotretinoin users showed significantly lower scores (p = 0.003). Clinically significant phobia was linked to treatment refusal, impaired quality of life, and increased healthcare-seeking, but not treatment discontinuation. Behavioral hesitation, social influence, and fear of side effects were the most common concerns. Isotretinoin phobia represents a significant barrier to acne management. The Isotretinoin Phobia Scale is a reliable tool for detecting at-risk patients. Early recognition and targeted counseling are crucial to reduce fears, improve treatment adherence, and prevent long-term acne complication.