Since the discovery of Accutane (Isotretinoin), newer generation of vitamin A derived products have also become available in the last decade. The two relatively newer retinoids are:
Adapalene: This drug is fast replacing Accutane in the treatment of mild acne. It has been shown to be effective for acne but also has fewer side effects. It causes less skin irritation, no sensitivity or allergy and has minimal or no photosensitivity. It is widely used in the treatment of mild acne.
Tazarotene: This drug has been around for about 10 years and is often used in the treatment of mild episodes of psoriasis and acne. Tazarotene is the first topical retinoid to be used for the treatment of psoriasis. The drug has the ability to decrease skin cells from proliferating and also posses strong anti inflammatory effects. The drug is often combined with corticosteroids in the treatment of psoriasis
In cosmetic medicine, Tazarotene has been shown to reverse some of the skin changes that occur from sun damage. A 0.1% cream applied daily has been shown to decrease or reverse
- facial wrinkles
- fine lines
- skin discoloration
- sun spots
When used in the treatment of mild acne, it has been shown to decrease the numbers of comedomes and skin redness.
Because the drug is not irritating to the skin, it is now widely being used instead of Tretinoin. However, there are reports which indicate that high does can cause severe irritation. Both the redness and skin irritation can be used if one starts off slowly with the drug use and allow the skin to get used to the drug
Like all other vitamin A derivatives, Tazarotene should be avoided by pregnant women and those who may become pregnant.
These newer retinoid compounds and advanced retinoid formulations now offer physicians and patients more effective topical retinoid medications with better safety profile and tolerability.
Even though some patients, particularly those with sensitive skin, may experience mild-to-moderate pruritis, erythema, burning, dryness, or peeling, these can be limited by starting the drug at a low dose and less often.
Patient education is a must when it comes to the retinoids. When used appropriately, these drugs offer highly efficacious treatment for both comedonal and inflammatory acne and are the foundation for most successful regimens for the treatment of acne.