Ocular Surveillance During Off-Label Oral Isotretinoin for Photoaging: A Review of Risks and Monitoring Recommendations.

BACKGROUND

Low-dose oral isotretinoin is increasingly used off-label for photoaging, with evidence of clinical and histologic skin improvement.

OBJECTIVE

To review ocular risks associated with isotretinoin in aesthetic use and propose monitoring recommendations.

METHODS

A narrative review of clinical studies, observational data, and mechanistic reports addressing isotretinoin-induced ocular effects was performed, integrating dermatologic and ophthalmologic perspectives.

RESULTS

Reported adverse effects include dry eye disease, meibomian gland dysfunction, and, rarely, retinal alterations. Risk may be cumulative in long-term or repeated cosmetic regimens.

CONCLUSION

A risk-adapted monitoring approach, emphasizing patient selection, informed consent, and interdisciplinary care, is recommended to balance cosmetic benefits with ocular safety.