Ann Dermatol.  2014 Dec;26(6):706-712. 10.5021/ad.2014.26.6.706.

The Effect of Evening Primrose Oil for the Prevention of Xerotic Cheilitis in Acne Patients Being Treated with Isotretinoin: A Pilot Study

• Park KY
• Ko EJ
• Kim IS
• Li K
• Kim BJ
• Seo SJ
• Kim MN
• Hong CK

• KMID: 2264865
• DOI: http://doi.org/10.5021/ad.2014.26.6.706

Abstract

BACKGROUND
The most common adverse effects of oral isotretinoin are cheilitis, skin dryness, dry eyes, and conjunctivitis, whereas evening primrose oil (EPO) is known to improve skin moisture and transepidermal water loss (TEWL) in healthy adults and atopic patients.
OBJECTIVE
To evaluate the clinical efficacy and safety of EPO in preventing xerotic cheilitis in acne patients being treated with oral isotretinoin.
METHODS
Forty Korean volunteers of Fitzpatrick skin types III and IV, having moderate acne, were enrolled and randomized to receive either isotretinoin with or without EPO for 8 weeks. The efficacy of treatment was evaluated on the basis of global acne grading system scores, number of inflammatory and noninflammatory lesions, TEWL, corneometry, physician's global assessment, and patient satisfaction.
RESULTS
The results after 8 weeks of treatment showed that the TEWL of the lip increased significantly during isotretinoin treatment, whereas the TEWL of the hand dorsum showed no significant change. The increase of the TEWL of the lip was more definite in the control group than in the experimental group. The number of acne lesions decreased significantly in both groups, and there were no differences between them.
CONCLUSION
Our study suggests that the addition of EPO improved xerotic cheilitis in acne patients being treated with oral isotretinoin. However, besides TEWL and corneometry assessments, additional studies are required for a complete understanding of the role of EPO in xerotic cheilitis in acne patients being treated with oral isotretinoin.

Keyword

Acne vulgaris; Evening primrose oil; Isotretinoin; Xerotic cheilitis

MeSH Terms

Acne Vulgaris*
Adult
Cheilitis*
Conjunctivitis
Hand
Humans
Isotretinoin*
Lip
Oenothera biennis*
Patient Satisfaction
Pilot Projects*
Skin
Volunteers
Water Loss, Insensible
Isotretinoin
Water Loss, Insensible

Figure

• 

  Fig. 1 (A) Although the experimental group tended to have a lower score than the control group for dryness of the hand dorsum, transepidermal water loss (TEWL) did not show significant differences between groups. (B) On the skin of the hand dorsum, corneometry did not show significant differences between groups. EPO: evening primrose oil.

• 

  Fig. 2 (A) On the lower lip, the experimental group tended to have a lower score than the control group for transepidermal water loss (TEWL), and there was a significant difference between the two groups after 8 weeks of treatment. (B) Corneometry showed no significant differences between the two groups. EPO: evening primrose oil.

• 

  Fig. 3 Clinical photographs of the lips during isotretinoin treatment. The control group (A~C) showed prominent xerotic cheilitis during the study period, and the experimental group (D~F) showed no significant cheilitis. From left: before treatment, 2 weeks later, and 8 weeks later.

• 

  Fig. 4 Concerning patient satisfaction levels during the treatment, most of the final ratings of satisfaction were "moderate" or "good" in both groups; *however, the experimental group was "significantly satisfied" at week 4. EPO: evening primrose oil.

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