Retinoids: Uses, most common brand names, and safety information
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In 1912, Frederick Hopkins discovered a nutrient in milk that would come to be recognized as vitamin A. Thirty years later, a study using a derivative of vitamin A called retinoic acid to treat acne was published. It took until the end of the 1950s before this topical retinoid finally started being routinely used in the treatment of acne. The first prescription retinoid product was marketed as Retin-A by Johnson & Johnson and is still available today. By the 1990s, a milder version was being developed as retinoic acid was known to increase skin irritation and sensitivity. An over-the-counter (OTC) form of vitamin A called retinol was this product. It is primarily used to reduce signs of aging, skin discolorations, and acne. There are several types of retinoids available today that are used to treat a number of skin conditions.
The list below includes retinoids approved by the U.S. Food and Drug Administration (FDA) and their pricing:
List of Retinoids
Retin A (tretinoin)
Retin A is indicated to treat acne vulgaris and facial wrinkles.
Retin A Micro (tretinoin)
Retin A Micro is indicated to treat acne vulgaris and facial wrinkles.
Retin A Micro Pump (tretinoin)
Retin A is indicated to treat acne vulgaris and facial wrinkles.
Renova is indicated to treat acne vulgaris and facial wrinkles.
Atralin Gel (tretinoin)
Atralin Gel is indicated to treat acne vulgaris and facial wrinkles.
Differin is indicated to treat acne vulgaris.
Tazorac is indicated to treat acne vulgaris, psoriasis, and wrinkles.
Arazlo is indicated to treat acne vulgaris, psoriasis, and wrinkles.
Aklief is indicated to treat acne vulgaris.
Accutane is indicated to treat severe, recalcitrant nodular acne.
Absorica LD (isotretinoin)
Absorica LD is indicated to treat severe, recalcitrant nodular acne.
Soiratane is indicated to treat psoriasis.
Targretin is indicated to treat T-cell lymphoma.
Other combination skin care products that contain vitamin A derivatives include:
- Veltin (clindamycin/tretinoin)
- Ziana (clindamycin/tretinoin)
- Epiduo Gel (adapalene/benzoyl peroxide)
What are retinoids?
Vitamin A-derived medications called retinoids are the most used anti-aging treatment. They are used on aging skin to reduce fine lines and wrinkles. Retinoids are also used as a treatment for comedonal acne and other dermatologic conditions. Dermatologists often say retinoids are an essential component of any skincare routine. They can be found in several formulations, including serums, creams, gels, and moisturizers.
Retinoids take time to work. For over-the-counter retinol products, it can take up to 6 months, and for Retin A (tretinoin) it can take 3 months to see its full benefit.
How do retinoids work?
Retinoids work by binding to retinoic acid receptors (RAR) inside the nucleus of the cell. Activating these receptors leads to increased skin cell turnover and faster removal of dead skin cells. Accelerating skin cell turnover also reduces pigmentation to lighten dark spots. Retinoids promote collagen production which helps fight wrinkles and have antioxidant activity that helps repair sun damage.
Prescription-strength retinoids block inflammatory pathways that lead to blemishes and lesions seen in acne and psoriasis. Inhibiting inflammatory chemicals such as cytokines and interleukins helps retinoids to reduce inflammation and slow the rate of plaque development.
What conditions are retinoids used to treat?
Retinoids are a class of medications used in the treatment of:
- Postinflammatory hyperpigmentation
- Certain types of skin cancers
- Actinic keratosis
- Kaposi’s sarcoma
- Cutaneous T-cell lymphoma
Are retinoids safe?
The use of retinoids is relatively safe and effective when taken as prescribed. Your prescribing physician should be aware of your medical conditions, including:
- An allergy to retinoids or any of the inactive ingredients in their product.
- Are pregnant, plan on becoming pregnant, or are breastfeeding. Soriatane (acitretin) and Accutane (isotretinoin) carry a black box warning that they are contraindicated in females who are pregnant or may become pregnant. Accutane (isotretinoin) carries a high risk of birth defects if used during any stage of pregnancy.
- Have skin allergies or dryness.
You should also make sure they are aware of all the medications you take, including prescription drugs, over-the-counter medications, vitamins, and supplements, as they may cause drug interactions:
- Tetracycline antibiotics such as Vibramycin (doxycycline) and Minocin (minocycline)
- Tegretol (carbamazepine)
- Eskalith (lithium)
- Trexall (methotrexate)
- Coumadin (warfarin)
Can you take retinoids while you are pregnant or breastfeeding?
Oral acitretin and oral isotretinoin treatment are known to cause fetal harm and adverse effects on infants so they should NOT be used during pregnancy or breastfeeding. These medications are typically only used in patients with severe acne. Patients taking oral retinoids are required to register in their respective REMS safety programs that help ensure pregnancy prevention to minimize exposure to the fetus. Women of reproductive age should not take oral retinoids unless an effective form of contraception (birth control) is established.
Topical retinoids are less likely to cause adverse effects on the unborn child or breastfeeding infant but are still not recommended due to the lack of data on their safety. While some experts say you can use retinol, retinaldehyde, and retinyl palmitate safely, it is generally not recommended. You should always discuss the risks and benefits of any medication you need with your healthcare provider if you are pregnant, plan on becoming pregnant, or are breastfeeding.
What are the common side effects of retinoids?
The most common side effects of retinoids can be managed through skin care measures such as wearing sun-protective clothing, sunscreen, moisturizers, or hydrating lotions. These side effects include:
- Dry skin
Retinoid use can sometimes cause more serious side effects including:
- Photosensitivity and increased risk of sunburn
- Worsening of psoriasis or eczema
- Skin discoloration
- Acne flare-up when first beginning treatment
- Stinging, blistering, and swelling of the skin
- Increased cholesterol and triglyceride levels
- Hair loss
This is not a complete list of side effects and we encourage you to consult with your healthcare professional for medical advice about any possible side effects.
How much do retinoids cost?
Retinoids are very expensive with an average cost of around $2,000 per year for the brand name medication.
You can purchase retinoids for $49 per month from NiceRx if eligible for assistance. Prices at the pharmacy vary by location, strength, and quantity, as well as your insurance status.
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