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Topical retinoids are creams, lotions and gels containing medicine derived from Vitamin A. These compounds result in proliferation and reduced keratinisation of skin cells independent of their functions as a vitamin.
Many brand-name creams containing the retinoids retinol and retinaldehyde can be obtained over the counter at pharmacies and supermarkets.
The more potent topical retinoids available on prescription are:
Adapalene gel has received approval from the FDA in the USA for over-the-counter use of acne treatment in patients 12 or older (July 2016). It is also available to treat acne in combination with benzoyl peroxide.
Tretinoin, isotretinoin and adapalene are used for:
Topical retinoids can irritate the skin, especially when first used in people with sensitive skin, resulting in stinging. Excessive use results in redness, swelling, peeling and blistering in treated areas. It may cause or aggravate eczema, particularly atopic dermatitis.
By peeling off the top layer of skin, they may increase the chance of sunburn. Irritation may also be aggravated by exposure to wind or cold, use of soaps and cleansers, astringents, peeling agents and certain cosmetics.
Some people have reported a flare of acne in the first few weeks of treatment, which usually settles with continued use.
Retinoids taken by mouth may cause birth deformities. Manufacturers recommend that topical retinoids are not used in pregnancy or breastfeeding as negative animal studies are not always predictive of human response. A systematic review did not show an increase in deformities in babies born after first-trimester exposure to topical retinoids.
Dryness due to a topical retinoid
Follow these instructions carefully.
If you are not based in New Zealand, we suggest you refer to your national drug approval agency for further information about medicines (eg, the Australian Therapeutic Goods Administration and the US Food and Drug Administration) or a national or state-approved formulary (eg, the New Zealand Formulary and New Zealand Formulary for Children and the British National Formulary and British National Formulary for Children).
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