Which medications in the drug class Retinoid-like Agents are used in the treatment of Acne Vulgaris?

Updated: Mar 26, 2019
  • Author: Jaggi Rao, MD, FRCPC; Chief Editor: William D James, MD  more...
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Answer

Retinoid-like Agents

These agents stimulate cellular retinoid receptors and help normalize keratinocyte differentiation and are comedolytic. In addition, they have anti-inflammatory properties. Oral isotretinoin also reduces sebum production in the skin. Retinoids are classified into 3 generations. The first comprises topical tretinoin and systemic isotretinoin. Acitretin is a second-generation retinoid used to treat psoriasis. The third-generation retinoids include topical adapalene tazarotene.

Topical tretinoin (Retin-A Micro, Atralin, Avita, Tretin-X, Renova)

Topical tretinoin inhibits microcomedo formation. It decreases cohesiveness of keratinocyesin sebaceous follicles, which allows for easy removal. It has anti-inflammatory properties. Topical tretinoin is available as a cream or gel.

Adapalene (Differin)

Adapalene inhibits microcomedo formation. It decreases cohesiveness of keratinocyesin sebaceous follicles, which allows for easy removal. It has anti-inflammatory properties. Adapalene is available as a cream, lotion, or gel.

Tazarotene (Tazorac, Fabior, Avage)

Tazarotene inhibits microcomedo formation. It decreases cohesiveness of keratinocyesin sebaceous follicles, which allows for easy removal. It has anti-inflammatory and immunological properties. Tazarotene is available as a cream or gel.

Isotretinoin (Claravis, Amnesteem, Absorica, Zenatane)

Isotretinoin is an oral retinoid indicated for recalcitrant, nodulocystic acne. It addresses all four pathogenic factors involved in the development of acne: follicular hyperkeratinization, inflammation, sebum production, and Cutibacterium acnes (formerly Propionibacterium acnes) growth. Treatment is weight-based, usually dosed initially 0.5 mg/kg and increased to 1 mg/kg in 2 divided doses for 15-20 weeks. Once-daily dosing is not recommended. The dose may be adjusted to administer up to 2 mg/kg/day. The patients must be registered into the government-regulated iPledge program in order to receive the medication.


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