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Sixty-five percent of the participants showed histologic improvements in the appearance and distribution of elastic fibers, while they all reported improvements in perceived skin quality.8 Two earlier studies had shown both histologic improvements (solar elastosis) and clinical improvements (reduced wrinkle depth and improved skin texture and color).9,10 No clinical or histologic differences, however, were detected in an RCT (n=32) comparing oral isotretinoin (20mg 3 times/wk) combined with sunscreen and moisturizer and sunscreen and moisturizer alone.11 The authors of a more recent systematic review of 6 studies (including 3 RCTs, Table 2) (n=251) concluded that isotretinoin might be a useful treatment for skin aging.7 There is, however, insufficient evidence to recommend oral isotretinoin over topical treatments

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