Topical retinoids

A group of medications for normalizing the cell lifecycle are topical retinoids such as tretinoin, adapalene and tazarotene . Like isotretinoin, they are related to vitamin A, but they are administered as topicals. They can, however, cause significant irritation of the skin. Tretinoin is the most and adapalene is the least irritant. These helps to prevent the hyperkeratinization of these cells that can create a blockage. Retinoids are the choice for treatment of comedonal acne. In appropriate cases, a topical retinoid can be used in the evening and an anti-inflammatory agent in the morning. Retinol, a form of vitamin A, has similar but milder effects and is used in many over-the-counter moisturizers and other topical products. Effective topical retinoids have been in use over 30 years but are available only on prescription so are not as widely used as the other topical treatments. Topical retinoids often cause an initial flare up of acne and facial flushing. Acne starts improving after 4 weeks. These are contraindicated during pregnancy.