Side Effects of tretinoin: A Synthesis of Findings from 21 Studies

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Original Abstract of the Article

Major Research Findings

Tretinoin is an oral retinoid used to treat severe, recalcitrant nodulocystic acne. 21 It works by reducing sebaceous gland size and sebum production, thus altering skin surface lipid composition. 21 Using tretinoin for 1-2 mg/kg/day for 3-4 months results in 60%-95% clearance of inflammatory lesions in patients with acne. 21 Doses as low as 0.1 mg/kg/day have also been proven successful in the clearance of lesions. 21 Encouraging results have also been seen in small numbers of patients with rosacea. 21 Side effects affecting the mucocutaneous system and raised serum triglyceride levels occur in most patients receiving tretinoin. 21 Tretinoin is strictly contraindicated in women of childbearing potential. 21

Reasons for Side Effects

Tretinoin is a retinoid derivative, and it has the effect of promoting cell growth and differentiation. 21 This effect is thought to accelerate skin turnover and cause side effects such as dryness and peeling. 21 Additionally, tretinoin reduces sebaceous gland size and sebum production, which can lead to dryness due to insufficient sebum. 21 Furthermore, tretinoin can cause photosensitivity. 21 This is because tretinoin has the effect of promoting melanin production in the skin. 21

Common Side Effects

Dryness

Tretinoin can cause dryness and peeling by accelerating skin turnover. 21 It is important to use a moisturizer thoroughly when using tretinoin. 21

Redness

Tretinoin can cause skin inflammation. 21 When using tretinoin, steroid ointments may be used in combination to reduce inflammation. 21

Peeling

Tretinoin can cause skin peeling by accelerating skin turnover. 21 It is important to use a moisturizer thoroughly when using tretinoin and consult a doctor if peeling is severe. 21

Photosensitivity

Tretinoin can cause photosensitivity. 21 When using tretinoin, be sure to use sunscreen and avoid going out during peak sunlight hours. 21

Other

In addition to the side effects listed above, tretinoin can cause side effects such as dry lips, blurred vision, fatigue, nausea, and vomiting. 21 Be aware of these side effects when using tretinoin. 21

Side Effects Countermeasures

Dryness Countermeasures

It is important to use a moisturizer thoroughly when using tretinoin. 21 Use a moisturizer before using tretinoin, after using it, or both. 21 Moisturizers containing ceramides are particularly effective. 21

Redness Countermeasures

When using tretinoin, steroid ointments may be used in combination to reduce inflammation. 21 Use a steroid ointment before using tretinoin, after using it, or both. 21 Use steroid ointments as directed by your doctor. 21

Peeling Countermeasures

When using tretinoin, use a moisturizer thoroughly, and consult a doctor if peeling is severe. 21 If peeling is severe, you may need to temporarily stop using tretinoin. 21

Photosensitivity Countermeasures

When using tretinoin, be sure to use sunscreen and avoid going out during peak sunlight hours. 21 Choose sunscreen with an SPF of 30 or higher and a PA++ rating or higher. 21 When using tretinoin, be sure to apply sunscreen before going out and reapply it frequently after going out. 21

Comparison Between Studies

Commonalities Between Studies

Many studies have shown that tretinoin is an effective drug for treating acne. 21 Many studies have also shown that tretinoin can cause side effects such as dryness and peeling by accelerating skin turnover. 21

Differences Between Studies

The severity of tretinoin side effects varies depending on the study. 21 This is thought to be due to differences in the age and gender of patients participating in the study, the severity of acne, and the amount of tretinoin used. 21

Cautions for Real-Life Applications

Tretinoin is an effective drug for treating acne, but it also carries the risk of side effects. 21 Follow your doctor's instructions when using tretinoin and be aware of side effects. 21 Also, tretinoin is absolutely contraindicated in women of childbearing potential. 21 If you are planning to become pregnant, stop using tretinoin. 21

Limitations of Current Research

There is still much that we do not know about tretinoin side effects. 21 Further research is needed to better understand tretinoin side effects. 21

Future Research Directions

The development of new drugs and treatment methods to reduce tretinoin side effects is needed. 21 Research to investigate tretinoin side effects in more detail is also needed. 21

Conclusion

Tretinoin is an effective drug for treating severe, recalcitrant nodulocystic acne, but it carries the risk of side effects. 21 Follow your doctor's instructions when using tretinoin and be aware of side effects. 21 Also, tretinoin is absolutely contraindicated in women of childbearing potential. 21

Literature analysis of 21 papers
Positive Content
15
Neutral Content
1
Negative Content
5
Article Type
2
0
0
2
21
1.

Concomitant administration of vitamin E does not change the side effects of isotretinoin as used in acne vulgaris: a randomized trial.

Author: StraussJ S, GottliebA B, JonesT, KooJ Y, LeydenJ J, LuckyA, PappasA A, McLaneJ, LeachE E

No improvement in retinoid side effects

Vitamin E did not significantly ameliorate retinoid side effects when combined with isotretinoin in the treatment of acne.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Novel and emerging treatment options for acne vulgaris

Author: AuffretNicole, ClaudelJean Paul, LecciaMarie-Thérèse, BallangerFabienne, DrenoBrigitte

Improved acne treatment

This review provides an update on the latest advances in acne treatment, including new formulations and emerging therapies. The review covers novel treatments like Clascosterone, Trifarotene, and Sarecy-cline, as well as improved formulations of existing compounds like minocycline and tretinoin. The emerging therapies target different aspects of acne pathogenesis, including sebaceous gland activity, inflammation, and the skin microbiome.

ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

The MYCN inhibitor BGA002 restores the retinoic acid response leading to differentiation or apoptosis by the mTOR block in MYCN-amplified neuroblastoma.

Author: LampisSilvia, RaieliSalvatore, MontemurroLuca, BartolucciDamiano, AmadesiCamilla, BortolottiSonia, AngelucciSilvia, ScardoviAnna Lisa, NiedduGiammario, CerisoliLucia, PaganelliFrancesca, ValenteSabrina, FischerMatthias, MartelliAlberto Maria, PasquinelliGianandrea, PessionAndrea, HreliaPatrizia, TonelliRoberto

Treat neuroblastoma

MYCN-amplified neuroblastoma (MNA-NB) is a deadly childhood cancer with poor prognoses and therapy resistance. Retinoic acid (RA) is beneficial for some patients, but the cause of RA resistance is unknown. This study explores the possibility of combining a MYCN-specific antigene oligonucleotide BGA002 and RA as a therapeutic approach to restore sensitivity to RA in neuroblastoma.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Papilledema and idiopathic intracranial hypertension due to the possible potentiation of ATRA by posaconazole in a case of acute promyelocytic leukemia.

Author: AtasUnal, Aydin ErsoyMerve, IltarUtku, YucelOrhan Kemal, TurkogluElif Betul, SalimOzan

IIH

This case report discusses the diagnosis and treatment process of idiopathic intracranial hypertension (IIH) emerging in a young acute promyelocytic leukemia (APL) case.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

10.

Tailoring of Retinyl Palmitate-Based Ethosomal Hydrogel as a Novel Nanoplatform for Acne Vulgaris Management: Fabrication, Optimization, and Clinical Evaluation Employing a Split-Face Comparative Study.

Author: SalemHeba F, KharshoumRasha M, AwadSara M, Ahmed MostafaMai, Abou-TalebHeba A

Decreased side effects
Improved drug efficacy

This study compares the performance of retinyl palmitate-decorated ethosomal hydrogel with tretinoin cream in treating acne vulgaris. It aims to improve drug efficacy and reduce side effects.

Clinical StudyResearch involving human participants to assess the safety, efficacy, and effects of an intervention/treatment.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

11.

Pharmacoepigenomics circuits induced by a novel retinoid-polyamine conjugate in human immortalized keratinocytes.

Author: GrafanakiKaterina, SkeparniasIlias, KontosChristos K, AnastasakisDimitrios, KorfiatiAigli, KyriakopoulosGeorge, TheofilatosKonstantinos, MavroudiSeferina, MagoulasGeorge, PapaioannouDionissios, ScorilasAndreas, StathopoulosConstantinos, DrainasDenis

Anti-inflammatory
Anticancer
Skin Diseases

RASP, a novel all-trans-Retinoic Acid (atRA)-spermine conjugate, demonstrated optimal in vitro and in vivo anti-inflammatory and anticancer efficacy without teratogenic or toxic side-effects. This study showed that RASP regulates the expression of miRNAs and genes related to cell proliferation, signal transduction and apoptosis in HaCaT cells, suggesting its potential benefits for skin diseases, including skin cancer.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

13.

Multidisciplinary corroboration in differentiation syndrome: a case report.

Author: SarkarSayan, GhoshPriya, GehaniAnisha, GharaNiharendu, BhattacharyyaParthasarathi

Life-threatening complication
Severe inflammatory response syndrome
Shock

Differentiation syndrome (DS), a life-threatening complication of acute promyelocytic leukemia treatment, can be diagnosed based on imaging findings alone, even in the absence of a low total leukocyte count. This case report highlights the importance of considering DS as a differential diagnosis in patients with lung nodules and ground-glass opacities during induction therapy.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

14.

Hypercalcemia associated with the interaction between all trans retinoic acid and posaconazole in an acute promyelocytic leukemia case.

Author: Afacan OzturkHacer Berna, AlbayrakMurat, MaralSenem, Reis ArasMerih, YilmazFatma, AkyolPınar, TigliogluMesut, MalkanUmit Yavuz

Hypercalcemia

All-trans retinoic acid (ATRA) is used to treat acute promyelocytic leukemia (APL). This case report describes a patient with APL who developed hypercalcemia after receiving ATRA in combination with posaconazole, an antifungal medication. The interaction between ATRA and posaconazole is thought to have potentiated the hypercalcemia.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

15.

4-Hydroxyphenyl Retinamide Preferentially Targets FLT3 Mutated Acute Myeloid Leukemia via ROS Induction and NF-κB Inhibition.

Author: ZhaoXin-Ying, ZhangRan-Ran, YeQian, QiuFei, XuHao-Yu, WeiFeng-Gui, ZhangHui

FLT3-ITD AML treatment
TKI resistance

This study investigated the effect of 4-HPR on FLT3-ITD mutated acute myeloid leukemia cells, showing preferential cytotoxicity towards FLT3-ITD positive cells and suggesting potential therapeutic applications.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

18.

Flexible liposomal gel dual-loaded with all-trans retinoic acid and betamethasone for enhanced therapeutic efficiency of psoriasis.

Author: WangWei, ShuGao-Feng, LuKong-Jun, XuXiao-Ling, SunMin-Cheng, QiJing, HuangQiao-Ling, TanWei-Qiang, DuYong-Zhong

Psoriasis Treatment

This work aimed to establish dual-loaded flexible liposomal gel for enhanced therapeutic efficiency of psoriasis based on all trans-retinoic acid (TRA) and betamethasone (BT).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

19.

Adverse events related to topical drug treatments for acne vulgaris.

Author: OtlewskaAgnieszka, BaranWojciech, Batycka-BaranAleksandra

Acne vulgaris treatment
<i>Cutibacterium acnes</i> resistance
Pregnancy contraindication
Skin irritation

Topical medications are a common treatment for acne. This review discusses the safety profile of different topical medications for acne. The most common side effect is skin irritation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

20.

Study of oral tranexamic acid, topical tranexamic acid, and modified Kligman's regimen in treatment of melasma.

Author: SahuPooja J, SinghAdarsh Lata, KulkarniSandeep, MadkeBhushan, SaojiVikrant, JawadeSugat

Melasma improvement
Side effects

A study of 60 patients with melasma found that a modified Kligman's regimen was the most efficient treatment, followed by oral tranexamic acid (TXA) and topical TXA. While the modified Kligman's regimen was more effective, its long-term side effects make oral TXA a promising therapeutic approach for melasma.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

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