Dermatologists should only be starting or continuing patients on isotretinoin for acne where the risks are outweighed by the benefits, according to interim guidance from the UK.

An individual patient’s need for acne therapy should be weighed against the risks of face-to-face consultations and uncertainty over reliable follow-up/monitoring over the coming months, the British Association of Dermatologists has advised.

Another major concern with isotretinoin during the social isolation phase of the pandemic is the ability for women to do pregnancy testing while using the teratogenic drug.

This may require additional counselling and information consultations via telehealth and consideration of home pregnancy testing, the Association suggests.

“If there is no risk of being pregnant, and the patient is exempt from the pregnancy [monitoring] program, then prescriptions for several months could be given at a time (taking into account need to monitor blood tests and side effects),” its statement on isotretinoin advises.

Monitoring for side effects and blood monitoring for the drug would need to be continue as usual but via with remote telehealth consultations.

The Association said there was also concern about the impact of isotretinoin’s drying effect on the mucous membrane to potentially increased risk of COVID-19 viral infection, but further information was being sought on this.