Objective:

To assess whether adolescent isotretinoin treatment for acne is associated with reductions in adult height, specifically focusing on treatment during adolescence.

Key Findings:

• Isotretinoin users had adjusted mean height differences of 0.3 cm among both men and women compared to the reference group, which is not clinically relevant.
• Height differences remained below the predefined threshold of 5 cm for clinical relevance.
• Cumulative isotretinoin exposure showed no dose-response association with adult height.
• Stunting occurred in 1.5% of isotretinoin users compared to 2.1% in the reference group.

Interpretation:

The findings suggest that isotretinoin treatment during adolescence does not have a clinically meaningful impact on adult height.

Limitations:

• The study was observational and exploratory beyond the primary hypothesis.
• Lacked repeated height measurements and information on factors like pubertal timing and nutritional status.
• Findings may not apply to high-dose isotretinoin regimens used for oncology or other conditions.
• The potential impact of a healthy-user effect on the findings should be considered.

Conclusion:

The study provides reassurance regarding the impact of isotretinoin on adult height, supporting evidence-based decision-making for its use in adolescents, particularly for clinicians and patients.