(1997; 132 pages) [French] [Spanish]
Tretinoin is the acid form of retinol. It is used topically in the treatment of acne. It is a keratolytic agent that reduces follicular hyperkeratosis by stimulating the turnover of epithelial cells. It is not significantly absorbed following topical application.
Treatment of mild to moderate acne vulgaris, especially in patients with a comedonal component.
Dosage and administration
The cream formulations cause less irritation than the gels. Treatment is usually started with the lowest-strength (0.025%) cream formulation. The strength can be increased as tolerance develops, to a maximum of 0.1%.
Adults and adolescents: a thin layer of cream should be applied to the affected areas once or twice daily, 30 minutes after washing. A therapeutic response characterized by redness and scaling occurs within 3-6 weeks. Treatment is usually continued for at least 3 months.
Hypersensitivity to tretinoin.
Use in pregnancy
The low blood levels that result from topically applied tretinoin have not been associated with an increase in fetal malformations. However, tretinoin should be used in women of child-bearing age only if the potential benefits outweigh the possible risks.
Care should be taken to avoid contact with the eyes, mucous membranes and open sores. Tretinoin may produce severe irritation of the skin in patients with eczema. Exposure to ultraviolet light increases the intensity of the inflammatory reaction.
Reversible local inflammatory reactions occur. Redness and scaling of the skin are necessary for a therapeutic response, but if severe erythema, blistering or crusting of the skin occurs, a lower-strength formulation should be used.
Concomitant use of other topical medications for acne should be avoided. Medicated soaps and topical lotions containing high concentrations of alcohol should be avoided, since they may cause stinging of treated skin.
Cream should be stored in tightly closed containers, protected from light.