Clinical Review: Topical Retinoids

Sheri L. Rolewski


Dermatology Nursing. 2003;15(5) 

In This Article

Dosage and Administration

Administration instructions contained in the product package insert may conflict with prescribed instructions when a drug is prescribed for off-label use. It's important to know what the patient may read and explain the differences to the patient, prior to prescribing off-label medications. Table 3 summarizes the use for approved indications only.

Application. Although package inserts often suggest using a pea-sized amount, our dermatology practice recommends applying 1 inch of the retinoid to the entire face on a nightly basis. This off-label application can be beneficial when addressing conditions such as acne, photodamage, intrinsic aging, actinic keratoses, lentigines, melasma, rosacea, and Darier's disease. By treating the entire face, efficacy can be enhanced, for the active ingredient works where it is placed. Spot treating should be avoided. This may reasonably decrease efficacy, and can lead to a blotchy appearance of the skin. Application should extend to the hairline and feather down along the jawline (Obagi & Bridenstine, 2000). Note: An inch is approximately the length of your distal finger (from the DIP to the tip).

Mucous membranes, corners of the nose, mouth, and eyes should be avoided. The upper and lower eyelids should be treated, however, if addressing photo damage or intrinsic aging. If contact with eyes occurs, rinse thoroughly with water.


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