Use of oral melatonin in female patients with acne and associated sleep quality disturbances

BACKGROUND: Sleep disturbances frequently accompany chronic dermatologic conditions and negatively impact patients' quality of life and emotional well-being, often exacerbating disease severity. Statistically, women are more frequently affected, with sleep quality disruptions linked to hormonal fluctuations across various life stages.

AIM: To evaluate the effect of oral melatonin intake on acne severity and quality of life in women.

METHODS: This prospective single-center study was conducted from 2023 to 2024 and included 130 women (mean age, 23.32 ± 2.75 years) diagnosed with mild to moderate acne. Acne severity was assessed using the Global Acne Grading System (GAGS); sleep disturbances were evaluated via the Pittsburgh Sleep Quality Index (PSQI); and the Dermatology Life Quality Index (DLQI) was used for psychosocial assessment. Laboratory monitoring included hormone profiling (luteinizing hormone, follicle-stimulating hormone, 17-hydroxyprogesterone, dehydroepiandrosterone sulfate, free testosterone) and metabolic parameters (insulin-like growth factor 1, insulin, and blood glucose) with HOMA-IR calculation.

RESULTS: Signs of dyssomnia were identified in 65.38% of patients (n = 85), with severity significantly correlating with acne grade (ρ = 0.565; p < 0.001). Patients with sleep disturbances experienced significantly lower quality of life (p < 0.001), elevated free testosterone levels (p < 0.001), and increased IGF-1 (p = 0.008). Combination therapy, including topical agents and oral melatonin administered 30 minutes before bedtime, resulted in faster regression of acne lesions, and improved psychosocial and sleep quality scores.

CONCLUSION: Sleep disturbances are highly prevalent among women with mild to moderate acne. Timely identification and correction of dyssomnia improves treatment outcomes and enhances quality of life.