Retinoids have become the drugs of choice for many skin disorders. The retinoids are all vitamin A derived drugs; useful for the treatment of acne and even psoriasis.
However, the drugs are not without side effects and all individuals who use these agents must be aware of the potential complications. The side effects of retinoid include:
Skin irritation: The majority of individual who use topical retinoid complain of skin irritation. This is much less with the newer formulations of retinoids. In the majority of cases the skin irritation varies from mild to moderate but sometimes can be intense. The common skin irritation symptoms are
- burning sensation
- skin peeling
- dry skin
Skin peeling and dryness usually are more prominent on areas of the face and upper arms. All the side effects are temporary and reversible when the drug is stopped. It is highly recommended that a moisturizer be used in conjunction with topical retinoids. In the rare case, the skin irritation can be very severe and lead to discontinuation of the drug.
Teratogenecity: The most feared complication of the retinoids is fetus damage during pregnancy. This is a known complication and all females of child bearing age must be aware of. It is the physician's responsibility to discuss this with females before giving out a prescription. The oral retinoids have long been recognized for causing fetal damage and numerous congenital malformations. After a prolonged course of oral retinoids, one should wait at least 3 years after stopping the drug, before one decides on a future pregnancy. In the USA there is a federal registry of all female patients who are administered oral retinoids
The topical retinoids are generally considered safe as the total amount of drug absorbed from the skin is very low. However, to be safe, one should avoid these drugs during pregnancy or breast feeding.
Newer retinoids have been formulated and there have been arguments about their safety profile in pregnancy. The best advice is to avoid these drugs if one is going to get pregnant
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