Topical Retinoids

Most dermatologists consider topical retinoids to be the mainstay of acne therapy. They're often the first-line prescription treatment for acne and they're also utilized as long-term maintenance for almost every acne patient. Retinoids are, far and above, the drugs of choice in people who have comedonal (blackhead and whitehead) acne, but they're also effective at fighting inflammatory lesions, so chances are that your dermatologist will start you off with one of these.

 

Retinoids are medications that are derived from vitamin A. Retinoids are comedolytic, which means that they work by making the skin shed more easily so that follicular plugs don't build up and form blackheads and whiteheads. In addition to helping you shed your skin, retinoids

 

Several brand-name topical retinoids, as well as generic preparations, are on the market. Many studies have been performed on the topical retinoids and the results don't clearly favor the use of one preparation over another. Individuals vary in their response to these agents and possible side effects, so you and your doctor will work together to find the best prescription for you.

 

Because of the known teratogenic effects (anything which produces nonheritable birth defects) of oral vitamin A, the use of topical retinoids in pregnancy has been an issue of concern. Although no studies have shown them to cause any birth defects, it is recommended that these drugs should not be used during pregnancy or breastfeeding.

 

Topical retinoids are applied in small, thin, pea-sized amounts to clean, dry skin once a day in the morning or at bedtime. They should be applied to all affected areas as well as to places that are acne-prone. Retin-A (not Retin-A Micro) and Avita, which tend to degrade in sunlight, should be applied only at bedtime. Talk with your doctor about the best time to apply Retin-A Micro, Differin, and Tazorac.

 

Dermatologists often start treatments with a lower strength preparation; in time, your doctor may prescribe higher concentrations of the active ingredient, if necessary, depending on your ability to tolerate them.

 

Within six to eight weeks, you should notice improvement if you have been using your product continuously. Maximal improvement most often occurs by three to four months.

 

Despite the common misconception, acne does not flare in the first few weeks of treatment; rather, the "flare" is due to irritation from the retinoid or from the natural progression of your acne, so try to "ride it through" unless the irritation is really severe — at which point you should call your dermatologist or healthcare provider.

 

It's not uncommon for retinoids to be used improperly and discarded before they have a real chance to work. Make sure you get both verbal and written directions from your doctor to make sure that you use your products correctly.