Severe Intracranial Hypertension as a Result of Topical Isotretenoin

Secondary intracranial hypertension occurs in patients taking oral isotretinoins and tetracyclines. In a small percentage of patients, this can be severe enough to cause irreversible optic nerve damage. It was previously thought that these medications had no cross-reactivity, thus patients with intracranial hypertension secondary to drug use have been prescribed medications from alternate drug classes. However, two cases demonstrate synergistic action between tetracycline and isotretinoin, even after the initial medications were withdrawn and visual function was recovered.