Acne Part 10

Retinoids

Retinoids, which are derivatives of vitamin A, act by decreasing comedomes and decreasing oil production. Retinoids are the most effective agents for acne. They have been a mainstay of acne treatment for the past 25 years.

Until recently, tretinoin was the only available topical retinoid. This agent is used as a single agent and quite effective for mild to moderate acne. Tretinoin is available as a cream, gel or liquid. The cream has the lowest potency, and the liquid has the highest potency. All tretinoin formulations can cause some skin irritation and this is related to the strength of the formulation.

Tretinoin is applied to clean dry skin. Because the drug can cause light sensitivity, sun exposure should be avoided when applying the treatment. Or the treatment can be applied at night time. To minimize irritation, tretinoin should be started at a low concentration, which can then be gradually increased as needed. Skin irritation usually decreases with continued therapy.

All users of tretinoin should be aware that when initially using the agent, a flare up may occur. This is common during induction therapy and not a sign of an adverse reaction. The skin flares up declines over the next few days.

Caution with Retinoids

Because of the known teratogenic (birth defects) effects of oral vitamin A products, the use of tretinoin in pregnancy is a major concern. When a female of child bearing age is prescribed tretinoin, the adverse effect on this drug on the fetus must always be explained to the individual. Numerous litigation cases have occurred with the use of these drugs in young females. A signed consent from the individual acknowledging the use of this drug must be placed in the chart.

Occasionally the retinoids may also cause an increase in the blood levels of fatty acids. Still in other individuals, the drugs have been associated with depression and suicidal thoughts.

Sun sensitivity may occur in some individuals who do take retinoids. Therefore it is recommended that the individual wear a sun screen or cover the skin while taking this medication

Topical Vitamin A products

Adapalene (Differin) and Tazarotene are two topical retinoids that have been approved for the use of Acne. These topical medications are applied once a day and are less irritating then benzyl peroxide and other antibiotics. Like the oral retinoids, the use of these drugs in pregnant females should be used with caution.

These vitamin A related products can treat several types of acne lesions. The retinoids may be applied topically or even be taken orally as a pill. When applied topically, they help to cleanse the pores and remove the skin oils. The oral retinoids are excellent for severe acne and lead to rapid clearance of the condition. They have a peeling action on the skin. Within a few weeks, the majority of individuals show a response and the drug also leads to a reduction in wrinkles on the face.