Retin-A
Retin-A (generic name: Tretinoin) is a derivative of vitamin A. Topical tretinoin is used in the treatment of mild to moderate acne and on skin that has been damaged by excessive exposure to the sun. Retin-A irritates the skin and causes the cells of the skin to grow (divide) and die more rapidly, increasing the turnover of cells. The number of layers of cells in the skin actually is reduced. In patients with acne, new cells replace the cells of existing pimples, and the rapid turnover of cells prevents new pimples from forming. By a similar mechanism, Retin-A can reduce some wrinkles, areas of darkened skin, and rough areas of skin, all of which occur in sun-damaged skin. In patients with sun-damaged skin, improvements in the skin usually are seen within the first 3 to 4 weeks of treatment. Brown spots begin to fade after six to eight weeks. Wrinkles decrease or disappear after three to six months. Following application to the skin, a minimal amount of drug is absorbed into the body. The FDA approved topical tretinoin (Retin-A) in 1971.
Combining other topical acne medications (for example, salicylic acid) with tretinoin may lead to excessive skin irritation. Use of abrasive soaps or cleansers, astringents, skin waxes and other products that irritate the skin may add to tretinoin induced skin irritation. Medications [for example, tetracycline (Achromycin)] that cause sun sensitivity should not be combined with tretinoin because of additive sun sensitivity.
Retin-A side effects
Following the application of tretinoin to the skin, there often is local inflammation. This reaction disappears when treatment is stopped. Mild stinging or a sensation of warmth also can occur when applying tretinoin. Dryness, scaling, and redness occur frequently. If severe redness, vesicles or crusting develops, a physician should be notified immediately and tretinoin stopped. It may be possible to restart therapy with a lower concentration.
Some patients using tretinoin develop increased sun sensitivity and are more prone to sunburn (photosensitivity). Therefore, it is advisable to avoid exposing treated areas of the skin to excessive sunlight or UV lamps to reduce the risk of severe sunburn.
