Dermatology Book

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TretinoinAka: Retin A

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  1. Indications
    1. Acne Vulgaris
    2. Photodamaged skin
  2. Available Preparations
    1. Cream 0.025% 0.05% 0.1%
      1. 0.025% as effective, less irritating than .05-.1%
      2. simply takes a little longer for improvement
    2. Gel 0.025% 0.01%
    3. Lotion 0.05% (Avoid - VERY irritating)
    4. Less irritating agents
      1. Retin-A Micro (Tretinoin gel microsphere)
      2. Avita (Tretinoin 0.025%)
  3. Directions for use
    1. Apply one dot per one triangle of face
    2. Initially apply only for a few hours
      1. Slowly increase length of treatment
      2. Titrate up to overnight application as tolerated
    3. Often used with Topical Antibiotics (e.g. Clindamycin)
      1. Clindamycin reduces irritating effect of tretinoin
      2. Example schedule
        1. Morning: Clindamycin applied
        2. Evening: Tretinoin applied
  4. Adverse Effects
    1. Scaling
    2. Skin dryness
    3. Local irritation, erythema or inflammation
      1. Creams irritate less than lotions
      2. Irritation can be reduced by adding Hydrocortisone
        1. 1 part Retin A 0.025%, 1 part Hydrocortisone 1%
    4. Local skin sensation of burning or stinging
    5. Local Pruritus
    6. Photosensitivity
    7. Initially exacerbates inflammatory lesions
  5. Efficacy
    1. Most potent Comedolytic
    2. Good results in 75% of patients in 3 months
  6. Mechanism
    1. Comedolytic
    2. Lowers cohesiveness of follicular epithelial cells
      1. Decreases micro-comedo formation
    3. Increases follicular cell turnover
      1. Results in extrusion of existing comedones

Tretinoin (C0040845)

Definition (MSH)An important regulator of GENE EXPRESSION during growth and development, and in NEOPLASMS. Tretinoin, also known as retinoic acid and derived from maternal VITAMIN A, is essential for normal GROWTH; and EMBRYONIC DEVELOPMENT. An excess of tretinoin can be teratogenic. It is used in the treatment of PSORIASIS; ACNE VULGARIS; and several other SKIN DISEASES. It has also been approved for use in promyelocytic leukemia (LEUKEMIA, PROMYELOCYTIC, ACUTE).
Definition (NCI)A naturally-occurring acid of retinol. Tretinoin binds to and activates retinoic acid receptors (RARs), thereby inducing changes in gene expression that lead to cell differentiation, decreased cell proliferation, and inhibition of tumorigenesis. This agent also inhibits telomerase, resulting in telomere shortening and eventual apoptosis of some tumor cell types. The oral form of tretinoin has teratogenic and embryotoxic properties.
Definition (NCI)A drug that belongs to the family of drugs called retinoids. It is used in the treatment of acne and is being studied in cancer prevention.
Definition (PDQ)A naturally-occurring acid of retinol. Tretinoin binds to and activates retinoic acid receptors (RARs), thereby inducing changes in gene expression that lead to cell differentiation, decreased cell proliferation, and inhibition of tumorigenesis. This agent also inhibits telomerase, resulting in telomere shortening and eventual apoptosis of some tumor cell types. The oral form of tretinoin has teratogenic and embryotoxic properties. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=41258&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=41258&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C900" NCI Thesaurus)
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
Englishall trans Retinoic Acid, ATRA, Retinoic Acid, TRA, trans Retinoic Acid, Trans Vitamin A Acid, Tretinoin, TRETINOIN PREPARATION, Tretinoinum, Vitamin A Acid
Spanishácido de vitamina A, ácido retinoico, acido de vitamina A, acido retinoico, tretinoína, tretinoina
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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