Association Between Adolescent Isotretinoin Use and Adult Height: Findings From a Nationwide Danish Population Study

Original Article : Isotretinoin Treatment in Adolescence and Adult Height

What are the key takeaways of this article?

Isotretinoin is an effective treatment for moderate-to-severe acne, but concerns have persisted regarding its potential effects on skeletal development and linear growth during adolescence. Because isotretinoin is a retinoid and rare case reports have suggested a link to premature closure of growth plates, questions remain about whether treatment during adolescence may reduce final adult height.

To address this concern, Schmidt et al. (2026) conducted a nationwide population-based cross-sectional study based in Denmark, published in JAMA Dermatology. The study included 379,196 individuals who were eligible for military conscription examinations between 2001 and 2015. Adult height measured at approximately 19 years of age was compared among individuals treated with isotretinoin, oral tetracycline antibiotics, topical acne therapies, and those with no recorded acne treatment.

The study found no evidence that isotretinoin use during adolescence was associated with reduced adult height. Compared with individuals who had not received acne treatment, isotretinoin users had nearly identical adult heights. Among men, the adjusted mean difference in height was +0.31 cm (95% CI: 0.20 to 0.41 cm), while among women it was +0.25 cm (95% CI:  −0.47 to 0.96 cm). These differences were substantially below the researchers' predefined threshold for clinical significance of 5 cm.

The investigators also examined whether age at treatment initiation or cumulative isotretinoin dose influenced adult height. Although slightly lower heights were observed among a small subgroup of males who began treatment before age 13, the differences were less than 2 cm and not considered clinically meaningful. Furthermore, no dose-response relationship was identified, indicating that higher cumulative exposure to isotretinoin was not associated with shorter adult stature.

Analysis of stunting, defined as height more than two standard deviations below the population mean, similarly revealed no increased risk among isotretinoin users. Findings remained consistent across multiple sensitivity analyses.

The study's major strengths include its large sample size, nationwide coverage, objective measurement of height, and detailed prescription data. However, the authors noted limitations, including the relatively small number of young female isotretinoin users and the inability to assess changes in growth velocity over time. Additionally, there was a lack of information on pubertal timing, nutritional status, and parental height.

Overall, this study provides strong evidence that isotretinoin treatment for acne during adolescence does not result in clinically meaningful reductions in adult height. These findings may offer reassurance to clinicians, patients, and families and support the use of isotretinoin when clinically indicated for moderate-to-severe acne.

Publication Date: July 16, 2026

Reference:

Schmidt SAJ, Grønborg TK, Gribsholt SB, Langan SM, Sørensen HT, Barbieri JS. Isotretinoin Treatment in Adolescence and Adult Height. JAMA Dermatol. Published online May 20, 2026. doi:10.1001/jamadermatol.2026.1197

Summary By: Miranda Branyiczky