How do topical retinoids work

Skin conditions that may be treated with topical retinoids Localised Kaposi sarcoma. Dryness due to a topical retinoid. Retinoids act at a cellular level. They activate genes involved in the physiology of keratinocytes by binding to specific nuclear receptors, retinoic acid receptor RAR and retinoid X receptor RXR. Topical retinoids such as retinol and retinaldehyde are commonly added to cosmetics.

Prescribed topical retinoids include adapalene, alitretinoin , tazarotene, tretinoin, and trifarotene. They come in a variety of formulations. Gels are the least cosmetically noticeable; creams are the least irritating. Applying them at night or just before sleep mean they are less noticeable when treating the face.

New Zealand approved datasheets are the official source of information for prescription medicines, including approved uses and risk information.

Check the individual New Zealand datasheet on the Medsafe website. See smartphone apps to check your skin. Books about skin diseases Books about the skin Dermatology Made Easy book. DermNet NZ does not provide an online consultation service. If you have any concerns with your skin or its treatment, see a dermatologist for advice. Topical retinoids — codes and concepts open. Treatment or procedure. C, EK2Y. Alitretinoin: a comprehensive review. If you find Step is 1 too irritant, contact the Office and we will be able to dispense a weaker version of Tretinoin to you.

If you find that moving to a new step causes your skin to become very irritated, then drop back down to the step before for another 6 weeks before trying again to go up a step. If you try again and your skin still gets irritated a second time, then stay at the highest step that you can tolerate without irritation. These are the things you should do to support your skin so that it can tolerate a topical retinoid. There are some areas on the skin that are very prone to irritation from a topical retinoid and need to be protected.

Apply all the precautionary measures for the very beginning, before there are any signs of irritation. This will reduce the chance that your skin becomes irritated. Topical retinoids are likely to make you more sensitive to the sun. Avoid going into direct sunlight and always wear a hat. Use sunblock judiciously — too much sun block can aggravate acne and cause irritation. Make an appointment. How to use a topical retinoid - Factsheet Dr Rajpar explains how you should use a topical retinoid including Tretinoin, Adapalene, Retinol and Retinaldehyde.

How to use a topical retinoid This fact sheet explains how you should use a topical retinoid. You should follow these instructions if you have been prescribed the following products: Tretinoin — Tretinoin 0. Tretinoin cream is still available from our clinic in various concentrations. Make an appointment Call us now. Why have I been prescribed topical retinoids?

Topical retinoids are prescribed for Acne Scarring Anti-ageing Other dermatological conditions such as hyperpigmentation, melasma, and keratosis pilaris Patience and consistency get results Topical retinoids are fantastic medications and they have been used by Dermatologists for almost 50 years.

How do I know if I have resilient skin? Principles of using a topical retinoid The principles of using a topical retinoid are to: Use small quantities to start with and build up the quantity gradually Apply the topical retinoid less frequently to start with and build up gradually Protect your skin from developing irritation from the topical retinoid Apply the topical retinoid at night — make sure it goes on your skin after cleansing and that you put nothing else on afterwards How to use your topical retinoid Step 1.

Step 3. Apply the topical retinoid every night. How to protect your skin from developing irritation These are the things you should do to support your skin so that it can tolerate a topical retinoid. Mild, noninflammatory acne can be treated by topical retinoids alone. If the comedonal lesions present together with inflammatory lesions topical retinoids should be combined with antimicrobial agents. As the combination treatment targets multiple pathophysiological factors, it is possible to get faster and permanent results.

In the first-line treatment of moderate inflammatory acne, topical retinoids are recommended in combination with antimicrobial agents. Topical retinoids are the essential part of the maintenance treatment of acne [ 1 — 4 , 13 , 14 ]. Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution 3. Help us write another book on this subject and reach those readers. Login to your personal dashboard for more detailed statistics on your publications.

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Downloaded: Abstract Acne vulgaris is the most common skin disease in adolescents and young adults and has serious influence on quality of life of the patients. Keywords acne retinoids topical treatment. Acne 1. Clinical features of acne vulgaris Acne vulgaris is characterized by the presence of comedones and suggested to be a chronic disease. Pathophysiology of acne The first step in the treatment of acne is to understand the pathophysiology of disease and to act on all factors involved in the development of acne.

Increased sebum secretion from sebaceous glands Secretion of inflammatory mediators Altered keratinization and follicular plugging Follicular colonization of P. Table 1. Four major steps in the pathogenesis of acne. Topical treatment of acne Reviewing the guidelines on the treatment of acne, a recommended common approach is outlined in Table 2 [ 1 — 4 ].

Table 2. Recommended general approach for the treatment of acne. Table 3. Topical agents for the treatment of acne. The importance of topical retinoids in the treatment of acne Topical retinoids have multiple effects in the treatment of acne and act on more than one factor implicated in the etiology of acne Table 4 [ 1 — 4 , 12 — 14 ]. Prevent the formation of microcomedones and reduce their number Reduce macrocomedones Promote the normal desquamation of follicular epithelium Exert anti-inflammatory effects Enhance the penetration of other drugs Prolong the remission periods of acne by inhibiting the of microcomedone formation and preventing the development of new lesions Prevents bacterial resistance.

Table 4. Multiple effects of topical retinoids in the treatment of acne. Introduction Retinoids are vitamin A retinol or functional analogs with vitamin A activity. Table 5. Retinoid receptors and their endogenous ligands. Topical retinoids used in the treatment of acne Tretinoin and isotretinoin are the first-generation retinoids whereas adapalene and tazarotene are the third-generation retinoids.

Tretinoin cis retinoic acid isotretinoin Adapalene Tazarotene. Table 6. Topical retinoids used in the treatment of acne. Tretinoin Tretinoin is the first retinoid studied and has been used more than 30 years in the treatment of acne. Adapalene Adapalene is a third-generation retinoid.

Isotretinoin cis retinoic acid is produced from the isomerization of retinoic acid. Tazarotene Tazarotene is a third-generation retinoid and its active metabolite is tazarotenic acid and it can bind all three types of RARs. Others Retinaldehyde has a pivotal role in the natural vitamin A metabolism of keratinocytes. The evaluation of comparative studies Nast et al.

Comedonal acne Topical retinoids were found to show comparable-to-superior efficacy on noninflammatory lesions when compared to benzoyl peroxide [ 7 ].

Papulopustular acne The efficacy of adapalene against inflammatory lesions was comparable to azelaic acid, BPO, tretinoin, and isotretinoin. Patient tolerability and safety Adapalene was found to display the best tolerability and safety among the topical retinoids followed by isotretinoin and tretinoin [ 7 ]. Factors affecting therapeutic compliance of patients Treatment with less irritant topical retinoids was associated with better patient tolerance. The safety profile of topical retinoids The major side effects of topical retinoids are local skin reactions such as erythema, scaling, dryness, burning, and stinging; rarely, they can cause pustular eruption.

Practical applications According to an investigation, dermatologists prescribe topical retinoids as second-line treatment after clindamycin, oral minocycline, and topical BPO [ 25 ]. More Print chapter. How to cite and reference Link to this chapter Copy to clipboard. Available from:. Over 21, IntechOpen readers like this topic Help us write another book on this subject and reach those readers Suggest a book topic Books open for submissions.

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