S. Saling1, D. Kennedy2
Isotretinoin is an effective treatment for acne and has revolutionised the management of severe cystic acne. However, it is also a potent human teratogen and because it is predominantly used in young women of childbearing age, this can become a significant concern. Along with systemic retinoids are topical solutions that are more frequently being prescribed for mild acne and other cosmetic indications, where there is limited data on teratogenicity when used in this form. MotherSafe is the NSW Statewide Medications in Pregnancy and Lactation Advisory Service and was established to address concerns about exposure during pregnancy and breastfeeding. It is a telephone-based service where patients as well as healthcare professionals can seek advice on exposure to medications and potentially harmful substances. This study aimed to analyse calls to MotherSafe from 2000–2015 to determine any changes in patterns of use of retinoids and in prescribing practice.
Results alarmingly suggest that there is still significant public concern about exposure to teratogenic retinoids in pregnancy, with 55% of calls regarding topical retinoids and 44.5% of calls regarding isotretinoin. The majority of calls (62%) were regarding retinoid exposure during pregnancy, with a small percentage (5.6%) regarding paternal exposure.
This study suggests ongoing problems surrounding the prescribing and dispensing of retinoids in NSW Australia, and the need for educating the public on dangers of teratogenic medication use in pregnancy.