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What are topical retinoids?

Derived from Vitamin A, topical retinoids are medications in the form of lotions, creams, gels, serums, etc [3].

Topical retinoids with antimicrobial therapy

In the last decade, experts in dermatology have developed several recommendations and guidelines to aid clinicians in selecting treatments for acne [1]. These recommendations are based on clinical trial data and bench data that show the effectiveness of a topical retinoid and antimicrobial therapy in treating acne. 

Dermatology experts, such as the American Acne and Rosacea Society and the Global Alliance to Improve Outcomes in Acne, suggest that a combination of topical retinoid and antimicrobial therapy is the best approach for most patients. 

 

Furthermore, recent evidence-based guidelines from the American Academy of Dermatology and the European Dermatology Forum agree that retinoids play an essential role in treating this common disease [1].”

Benefits of using topical retinoids for acne prone skin

Haven’t heard of topical retinoids used for acne before? Well, the National Library of Medicine confirms that past studies indicate the prescribed topical use of retinoids are under-used for acne treatments [2]. 

 

You may have used or heard of a topical retinoid before. Common types of prescription and over the counter retinoids include tretinoin, tazarotene, and adapalene.

“The AAD guidelines state that “retinoids are the core of topical therapy for acne because they are comedolytic, resolve the precursor microcomedone lesion, and are anti-inflammatory;” furthermore, they “allow for maintenance of clearance” [4].” 

                                                                           National Center for Biotechnology Information

Benefits of topical retinoids for acne treatment:

Benefits include:
  • Reduces visible Lesions
  • Prevents the development of microcomedones (blemishes) & new lesions
  • Acts to normalize flaky skin
  • Reduces excess keratin production 
  • Blocks inflammatory pathways
  • Lightens hyperpigmentation
Topical Retinoid Serum

“The use of retinoids plus BPO targets multiple pathways and can often eliminate the need for antibiotics, reducing the likelihood of antimicrobial resistance [5].” 

                                                                           National Center for Biotechnology Information

How to use topical retinoids for acne treatment

Depending on the type of topical vehicle in use (cream, lotion, gel, etc), it is recommended to use a pea sized amount over the affected area once a day about 20-30 minutes after washing your face. Always follow the instructions for your topical retinoid or your dermatologist’s recommendations [6].

Precautions to take while using topical retinoids

Topical retinoid therapy may cause some skin irritation such as peeling, redness, irritation, or dryness. This usually occurs within the first few weeks of treatment and then reduces gradually. The irritation caused by retinoids is not severe and is limited to the top layer of the skin. Retinoids should not be used while exposed to direct sunlight. Typical uses of retinoids are used in a “night” routine for skincare to avoid sun exposure [7].

Recommendations for acne prone skin

Incorporating a topical retinoid along with the use of an antimicrobial can significantly optimize your skincare routine. Note: it is not recommended to use an antimicrobial soap for acne. A superior choice for an antimicrobial is a serum. An acne serum along with a topical retinoid is a combination that can improve hydration, reduce inflammation, and balance the PH in your skin [7].

 

  1. Leyden, James, et al. “Why Topical Retinoids Are Mainstay of Therapy for Acne.” Dermatology and Therapy, Sept. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5574737/. 
  2. “Comedones: Medlineplus Medical Encyclopedia.” MedlinePlus, medlineplus.gov/ency/article/003236.htm#:~:text=Comedones%20are%20small%2C%20flesh%2Dcolored,middle%20of%20the%20small%20bump.  
  3. “Topical Retinoids.” DermNet, dermnetnz.org/topics/topical-retinoids. 
  4. Zaenglein AL;Pathy AL;Schlosser BJ;Alikhan A;Baldwin HE;Berson DS;Bowe WP;Graber EM;Harper JC;Kang S;Keri JE;Leyden JJ;Reynolds RV;Silverberg NB;Stein Gold LF;Tollefson MM;Weiss JS;Dolan NC;Sagan AA;Stern M;Boyer KM;Bhushan R; “Guidelines of Care for the Management of Acne Vulgaris.” Journal of the American Academy of Dermatology, pubmed.ncbi.nlm.nih.gov/26897386/. 
  5. Gollnick H;Cunliffe W;Berson D;Dreno B;Finlay A;Leyden JJ;Shalita AR;Thiboutot D; ; “Management of Acne: A Report from a Global Alliance to Improve Outcomes in Acne.” Journal of the American Academy of Dermatology, pubmed.ncbi.nlm.nih.gov/12833004/. 
  6. “Topical Retinoids and Application.” Cosmetic Dermatologist – Skin & Facial Rejuvenation – Dermatology, www.dermanetwork.org/glossary/2007-11-topical_retinoids_and_applicat.html.  
  7. J;, Levin. “The Relationship of Proper Skin Cleansing to Pathophysiology, Clinical Benefits, and the Concomitant Use of Prescription Topical Therapies in Patients with Acne Vulgaris.” Dermatologic Clinics, pubmed.ncbi.nlm.nih.gov/27015773/.