Topical Retinoids FAQ

Tretinoin, Adapalene, Tazarotene: Side Effects and Precautions.

Nov 15, 2009 Hanish Babu

Topical retinoids frequently asked questions will review the side effects and precautions of these acne medications.

Topical retinoids, including tretinoin, isotretinoin, adapalene and tazarotene are the best medications available for use in acne but has some side effects that have to be addressed properly.

Is it Safe to Use Topical Retinoids in Pregnancy and Breast Feeding?

Topical and systemic retinoids are not recommended for use in pregnancy and breast feeding.

Are there Any Other Skin Conditions where Topical Retinoids Should be Avoided?

Topical retinoids are best avoided in cases of preexisting eczema, rosacea, any inflammatory conditions of the skin and diseases causing sun sensitization.

What are the Side Effects of Topical Retinoids in Acne?

Because of their desquamatory effects on the superficial skin layers, topical retinoids may cause mild to moderate irritation in some patients. Some patients may experience the following:

A burning or stinging sensation may be felt after application, mostly in the initial weeks.
Slight redness of the facial skin may occur between the first and fifth weeks of application
Some patients may experience worsening of the acne during the second to third weeks of treatment with topical retinoids. This is due to an inflammatory blowup of hidden comedones and papules lying underneath and is actually an encouraging sign.
Photosensitization to sunlight and artificial light sources is common with topical retinoids.

What are the Precautions to be Taken While Applying Topical Retinoids in Acne?

Topical retinoids can cause irritation of the facial skin due to the peeling effect of the medications. Following precautions will help reduce the irritation:

To begin with, use the lowest strength (0.025%) of the retinoid (tretinoin or isotretinoin). Later, a higher strength may be used when the skin becomes tolerant.
Initially, there may be a stinging or burning sensation after applying the retinoid and the skin may turn red. In such cases, the retinoid can be washed off after two hours during the first two weeks. When the irritation subsides, the retinoid may be kept throughout the night.
As the skin is easily sensitized to sun while on retinoids, it is wise to avoid excess sun exposure during the peak hours, from 10 am to 4 pm. While going outdoors, apply a non-comedogenic sunscreen during daytime.
Apply topical retinoids only during night.
Avoid applying retinoids near the eyes, nose and mouth.
If the irritation occurs, apply a non-comedogenic moisturizer like sebium cream in the morning.
Avoid excessive washing of the face.

Also, as the skin structures are being regenerated and the underlying dermal collagen restructured, the skin will be very sensitive to lasers and other procedures like facial peelings, resurfacing, dermabrasions, and so on. It is imperative to stop retinoids at least two weeks before such procedures. Lasers can cause burns if used on retinoid applied skin.

Topical Retinoids FAQ: Related Articles

Topical Retinoids in Acne: The Best Topical Medication for Pimples. Topical retinoids are the best medications available for local use in the treatment of acne.
Effective Usage of Topical Medications in Acne: How to Get Rid of Pimples with Creams, Gels and Lotions. Topical medications are useful alone in the mild type and in combination with oral therapies in the moderate to severe types of acne.
Acne Topical Medications FAQ: How to Deal with the Common Side Effects of Acne Creams and Gels. Many acne sufferers are unaware of the benefits of topical medications in acne. There are certain precautions to be taken while choosing and using the acne topical formulations.

Sources:

Sanjiv Jain. Acne in Fun with Dermatology. Jaypee Brothers, New Delhi. 1998; 1: 92-98
Breathnach SM et al. Systemic Therapy in Rook’s Textbook of Dermatology. 2004; 4:72.15-17.
Fitzpatrick's Color Atlas & Synopsis of Clinical Dermatology, Fifth Ed, 2005.

Disclaimer

The information given in this article is for educational purposes only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, Dr.Hanish Babu, MD or Suite101 will not be responsible for any consequences. The images provided are for illustration purposes only.

The copyright of the article Topical Retinoids FAQ in General Medicine is owned by Hanish Babu. Permission to republish Topical Retinoids FAQ in print or online must be granted by the author in writing.

Topical Retinoids: Frequently Asked Questions.