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Retinoids: Topical

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Retinoids are a class of medications derived from vitamin A that are used to treat a variety of skin conditions, including acne, aging skin, and psoriasis.

Topical retinoids are formulated for use on the skin and are available in the U.S. by prescription only.  There are several brands of topical retinoids available, including:

  • Adapalene (Differin)
  • Tazarotene (Tazorac)
  • Tretinoin (Retin A Micro, generic)
  • Combination treatments, such as Epiduo Gel (adapalene + benzoyl peroxide) and Ziana (tretinoin + clindamycin)

All topical retinoids are safe and effective, but there are several common side effects, including skin dryness and irritation.  Irritation associated with topical retinoid use (“retinoid dermatitis”) occurs most commonly within the first 2 to 4 weeks of therapy and lessens with continued use. The regular use of a gentle skin cleanser and moisturizer can also help relieve the irritation.

Topical retinoids can also increase the skin's sensitivity to ultraviolet light. If you use a topical retinoid, you should also use a sunscreen with SPF of at least 15 to prevent additional skin irritation.

Topical retinoids are usually prescribed for use once per day, at night. The use at night is recommended because the sun’s UV radiation can degrade the medication and diminish its effectiveness.

Retinoids for the Treatment of Acne 

Topical retinoids are a primary component of acne management because of their unique ability to open clogged pores. This makes them a "first-line" therapy for people with mild, moderate and even severe acne. 

Because topical retinoids reduce inflammation and prevent new acne lesions (comedones) from forming, they are often prescribed for maintenance therapy to avoid the use of antibiotics and prevent the development of antibiotic resistance. The long-term use of topical retinoids for acne may also decrease the risk of developing acne scars and provide improved skin texture.

Topical retinoids may be used alone or in combination with other acne medications, such as benzoyl peroxide or antibiotics (erythromycin, clindamycin, or minocycline).

An international group of acne experts (The Global Alliance to Improve Outcomes in Acne) developed recommendations regarding acne therapy . This group reinforced the important role of topical retinoids (adapalene, tazarotene, tretinoin) in both the early and maintenance phases of acne management. 

Retinoids for the Treatment of Aging Skin (Fine Wrinkles)

Retinoids can help repair skin damage due to chronic sun exposure and natural aging.

Clinical studies of topical retinoids have also shown them to be effective in diminishing fine lines and superficial wrinkles. Retinoids may slow down the onset of wrinkles and extend the time between other wrinkle treatments.

Topical retinoids reduce signs of aging by stimulating collagen production, leading to a more youthful appearance.

Use at least 2-3 time a week can lead to noticeable improvement over two to 6 months. The benefits of using retinoids for aging skin include:

  • Visual reduction in the number and depth of wrinkles
  • Improvement of the skin's texture (smoother skin)
  • Reversal of abnormal pigmentation (fading of dark spots)

Treatment with a topical retinoid  should be started before the skin is significantly damaged.

Topical retinoids are not advised for people with rosacea (signs include facial redness, small blood vessels and occasional inflammatory papules).

© 2009 Vivacare. Last updated December 10th, 2009.

This information is for general educational uses only. It may not apply to you and your specific medical needs. This information should not be used in place of a visit, call, consultation with or the advice of your physician or health care professional. Communicate promptly with your physician or other health care professional with any health-related questions or concerns.

Be sure to follow specific instructions given to you by your physician or health care professional.