Isotretinoin-induced gynecomastia.

This brief report reviews the four published cases of isotretinoin-induced gynecomastia and argues that isotretinoin can, albeit rarely, cause persistent sexual dysfunction in the same manner as finasteride and serotonin-reuptake antidepressants — noting that unlike those drugs, sexual dysfunction is not even mentioned in isotretinoin's data sheet. It cites the 300-case series finding that isotretinoin alone accounted for as many enduring-dysfunction cases as fluoxetine and finasteride combined, and proposes anti-androgenic inhibition (with studies showing lowered testosterone) as the likely mechanism.