Aging is an inevitable process that affects every aspect of our lives, including our external appearance.
The skin, as the outermost organ of the body, prominently bears the signs of aging.

Factors of skin aging:

Two main processes cause skin aging:

Internal processes: These are related to natural biological processes that occur in the body with age, such as decreased production of collagen and elastin, impaired cell regeneration ability, and more.
External factors: These factors include sun exposure, air pollution, smoking, poor diet, and more.
Sun exposure is the most harmful external factor for the skin, causing cumulative damage, wrinkles, age spots, and skin cancer.

The aim of the research in this article is to examine the potential efficacy of low-dose oral isotretinoin
(also known as: Curatane, Roaccutane) in the treatment of skin aging.

Research method:

120 patients aged 35-65 years, who underwent various facial rejuvenation procedures, were divided into two groups of 60 patients each:

Group A (n=60): The treatment group, which received oral isotretinoin at a dose of 10-20 mg three times a week for two months, in addition to the facial rejuvenation procedures.
Group B (n=60): The comparison group, which underwent the same facial rejuvenation procedures but without oral isotretinoin.

Measures:

Patients underwent a clinical evaluation of skin appearance, including:

Wrinkles
Skin thickness and color
Pore size
Skin elasticity
Skin tone
Pigmented lesions

Results:

All patients in the treatment group noted improvement in skin appearance, including wrinkles, skin thickness and color, pore size, skin elasticity, skin tone, and reduction in pigmented lesions.
A statistically significant difference in improvement was found in the treatment group (Wilcoxon test <0.01).
The side effects of low-dose oral isotretinoin were mild and negligible.

In summary:

In the treatment group, there was an improvement in the overall appearance of the skin, regarding texture, wrinkle depth, and skin tone.
Skin thickness, elasticity, and pore size improved.
Both the number of collagen fibers and the density of elastic fibers increased statistically significantly.
Elastosis decreased, epidermal thickness increased, and the stratum corneum decreased.
A reduction in pigmented lesions and uneven hyperpigmentation was identified.
With a low dose of isotretinoin, side effects were absent or negligible, limited to minimal lip dryness.

Conclusions:

The study indicates that the use of oral isotretinoin, combined with facial rejuvenation procedures, may significantly improve the appearance of aging skin.
An additional advantage is that the side effects of the treatment are mild and negligible.

Importance of the study:

This is one of the first reports on the use of oral isotretinoin for the treatment of facial skin aging.
The study results are promising and offer a research direction for individuals interested in improving their skin appearance.

Important disclaimer:
The use of oral isotretinoin against skin aging is an off-label use and is not approved for this purpose. It is based on a few small studies of relatively low quality and has not yet been proven in large, controlled trials. In contrast, the first-line evidence-based treatment for skin aging includes topical retinoids (creams) along with daily sun protection (sunscreen). Taking oral isotretinoin, with its associated risks, must be done only under close medical supervision.

Important to note:
High-dose isotretinoin may cause:

Dry skin: Isotretinoin may cause extreme dryness of the skin, including the lips, nose, and eyes. This dryness may lead to itching, peeling, and skin cracks.
It is important to use moisturizer regularly during treatment.
Sun sensitivity: Isotretinoin may increase the skin's sensitivity to the sun, so it is important to use a broad-spectrum sunscreen (SPF 30 at least) every day,
even on cloudy days.
Vision changes: In rare cases, isotretinoin may cause vision changes, such as dry eyes, difficulty with night vision, and changes in color vision.
It is important to have regular eye exams during treatment.
Elevated blood lipids and liver damage: An increase in triglyceride and cholesterol levels is one of the most common side effects of isotretinoin, and in extreme cases may even trigger pancreatitis. Concurrently, the drug may impair liver function.
This is the main reason why it is important to have regular blood tests throughout treatment, to monitor both blood lipids and liver function.
Severe risk of birth defects (teratogenicity): This is the most dangerous side effect. Isotretinoin is a particularly potent teratogen: taking it during pregnancy, even at a low dose and for a short period, may cause severe birth defects in the fetus (facial and skull defects, heart and central nervous system defects) and miscarriage. Therefore, pregnant women, or women who may become pregnant, are absolutely prohibited from taking the drug.
Separately, long-term or high-dose use may cause bone changes (such as bone thickening, hyperostosis) which are usually mild and dose-dependent, and are not the reason for the pregnancy ban.
Depression and anxiety: There are reports of cases where isotretinoin caused depression and anxiety.
It is important to contact a doctor immediately if you experience these side effects.
Contraception in women of childbearing age: Due to teratogenicity, women of childbearing age must use two effective methods of contraception, starting one month before treatment begins, throughout the entire treatment period, and for at least one month after its completion. Additionally, negative pregnancy tests are required before starting treatment and during it.
Regarding men, the evidence for significant harm to fertility at therapeutic doses is weak and inconclusive, and the amount of the substance transferred to the partner through semen is negligible. However, those with concerns are advised to consult a doctor.