Topical Retinoids in Acne Treatment

The role of topical retinoids in acne treatment is in the forefront of therapy of comedonal acne. Retinoids are derived from Vitamin A (Retinol). They regulate cellular growth and differentiation by binding with nuclear receptors and altering gene activity. See the specific action of topical retinoids in acne treatment below.

1. Role of Topical Retinoids in Acne Treatment

   Topical retinoids are often the mainstay of treatment in the comedonal variety of grade 1 acne. They have an unmatched ability to unseat and prevent further development of comedones.

2. How does Topical Retinoids act in acne treatment?

   • They prevent and unseat comedones

   • Diminish desmosomal attachments and disrupt the lamellar intercellular lipid membranes that seem to glue the keratinocytes together. This has a kerato-regulatory effect, relieving the comedonal plugs.

   • Topical tretinoin also suppresses sebum production

   • Topical tretinoins also have an anti-inflammatory effect on the inflamed sebaceous gland.

3. What is the correct way to apply Topical Retinoids in Acne Treatment?

   Retinoids are applied as a thin layer at night. Application should be over the whole acne prone areas of the face, not just to the lesions. An amount the size of a pea taken on fingertip is sufficient for the whole face.

4. How long to apply Topical Retinoids in Acne treatment?

   A minimum application for 8-12 weeks is necessary before assessing the effectiveness of topical tretinoins in acne.

5. What are the precautions to be taken while applying Topical Retinoids in acne treatment?

   Retinoid dermatitis caused by contact irritation is very common following application of topical tretinoin. The following precautions may be taken to minimize the contact irritation:

   • Start with the lowest strength, i.e., 0.025% and gradually increase strength as the skin becomes accustomed or  'toughened' with repeat applications.

   • If there is a stinging or burning sensation and skin turns red after application, wash off after about 2 hours during the first week. Later, gradually increase the duration of application.

   • Avoid excess sun exposure. Use a suitable non-comedogenic sun screen during daytime

    

   Further Reading

• Adapalene, gel 0.1% in Acne

• Tazarotene, gel

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