July 29, 2016

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"The U.S. Food and Drug Administration today approved Differin Gel 0.1% (adapalene), a once-daily topical gel for the over-the-counter (OTC) treatment of acne. Differin Gel 0.1% is approved for use in people 12 years of age and older.


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Retin-A (tretinoin)

Pharmacy Author: Pharmacy Editor: Jay W. Marks, MD Drug Class: Topical acne agents Similar Drugs: Renova (tretinoin), Atralin (tretinoin), Avita (tretinoin), Retissa, Tretin-X, Retin-A Micro (tretinoin)

Side Effects or Adverse Reactions

Table 1. Common and Serious Side Effects of of Retin-A

Common Side Effects Frequency Serious Frequency
Peeling >10% Severe skin reactions No Information
Excessive dry skin >10%    
Burning/stinging >10%    
Erythema >10%    
Pruritus >10%    
Blistering 1%-10%    
Photosensitivity* 1%-10%    
Hyperpigmentation 1%-10%    

* Minimize sunlight, including sunlamp, exposure; sunscreen (SPF 15) and protective clothing over treated areas are recommended if exposure cannot be avoided.


Drug Interactions

Other topical medications that cause peeling or drying should not be combined with Retin-A. Examples include medicated or abrasive soaps and cleansers, products that have a strong drying effect, products with high concentrations of alcohol, astringents, benzoyl peroxide, sulfur, resorcinol, and salicylic acid.


Efficacy of Retin-A (tretinoin)

In 12 week studies, Retin-A Micro reduced acne lesions by 32% to 40% versus 8% to 23% for vehicle gel (placebo). Retin-A Micro was significantly better than vehicle in reducing acne lesions and was superior to placebo in investigator's global evaluation of clinical response.


Pharmacology (Mechanism of Action) of Retin-A

The exact mechanism of tretinion is not known. Tretinoin is a metabolite of vitamin A. Tretinoin causes skin cells to divide and die more rapidly, increasing cell turnover. It also modifies keratinzation of skin cells which reduces the formation of comedones. 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, tretinoin can reduce some wrinkles, areas of darkened skin (hyper-pigmentation), and rough areas of skin.

Retin A Micro FDA prescribing information
Micromedex: 1974-2012 Thomson Reuters

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