Reduced skin irritation with tretinoin containing polyolprepolymer-2, a new topical tretinoin delivery system: A summary of preclinical and clinical investigations

Quigley, John W.; Bucks, Daniel A. W.

doi:10.1016/s0190-9622(98)70139-2

Cited by 25 publications

(10 citation statements)

References 4 publications

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“…Polyolprepolymer-2 helps to retain drug molecules on the skin surface and in the upper layers of the skin [19, 20]. Another new formulation is a microsponge delivery system consisting of macroporous beads of 10–25 µm in diameter which are loaded with an active ingredient.…”

Section: Tretinoinmentioning

confidence: 99%

Topical Treatment in Acne: Current Status and Future Aspects

Gollnick

Krautheim²

2003

Dermatology

111

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During the last 20 years, the number of topical and systemic drugs for the treatment of acne vulgaris has been enriched. Topical drugs on the one hand have been newly discovered or further developments of already available agents such as in the group of retinoids or galenic formulation have improved efficacy or local tolerance. Topical retinoids are a mainstay in acne treatment since 1962. All-trans retinoic acid was the first and is still in use. Its irritative potential has led to the new galenics, i.e. incorporation in microsponges and in propolyomers, which increased the tolerability significantly. The isomer of tretinoin, isotretinoin, has the same clinical efficacy, but also a lower irritancy. A real breakthrough was adapalene, a retinoid-like agent, with a different retinoid receptor-binding profile, but in addition to the same clinical efficacy on inflammatory and non-inflammatory acne lesions compared to tretinoin, a better tolerability and, therefore, compliance. Unfortunately, over the past years topical retinoids have been less used in inflammatory acne than they should be, taking the the mechanisms of action into account. Topical antimicrobials, in particular topical antibiotics, should be used less often than in the past and only for short periods to avoid the development of resistances. It seems better to combine those agents with topical retinoids, with BPO or with azelaic acid to enhance the efficacy and slow down the development of resistance. BPO is still the gold standard for papular-pustular acne of mild-to-moderate type in concentrations of 2–5%. Azelaic acid is an alternative with efficacy on the comedo and is antibacterial without development of resistances. Finally, the physical removal by electrocautery or CO₂ laser of multiple densely packed closed comedones, macrocomedones and microcysts is necessary to enhance the efficacy of topical comedolytic agents and to speed up the therapeutic results. Photodynamic therapy has not yet been proven efficacious in controlled studies. Blue and red light can probably be used in association with local agents but enhancement of the irritative potential of topical and systemic agents has to be considered.

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Section: Tretinoinmentioning

confidence: 99%

Topical Treatment in Acne: Current Status and Future Aspects

Gollnick

Krautheim²

2003

Dermatology

111

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“…Many antibiotics have been shown to produce resistant P. acnes , and this is associated in some patients with clinical failure. New retinoid molecules such as adapalene [17, 18]have been developed, while old retinoids have been redeveloped using new vehicle delivery systems [42, 43]. It is not the intention of this review to discuss the pros and cons of such therapies, except to say that some newer drugs and new formulations of older therapies tend to show a better benefit/risk ratio.…”

Section: New Topical Retinoidsmentioning

confidence: 99%

Comedogenesis: Some Aetiological, Clinical and Therapeutic Strategies

et al. 2003

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Hypercornification is an early feature of acne and usually precedes inflammation. It is associated with ductal hyperproliferation, and there are many controlling factors such as androgens, retinoids, sebum composition and cytokines. Cycling of normal follicles and of comedones may explain the natural resolution of comedones and, in the longer term, resolution of the disease itself. There is a need to tailor treatment according to comedonal type. Suboptimal therapy can often result from inappropriate assessments of comedones, especially microcomedones, sandpaper comedones, submarine comedones and macrocomedones. Macrocomedones can produce devastating acne flares, particularly if patients are inappropriately prescribed oral isotretinoin. Gentle cautery under topical local anaesthesia is a useful therapy in the treatment of such lesions. The newer retinoids and new formulations of all-trans-retinoic acid show a better benefit/risk ratio.

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“…This is consistent with the literature, which reports the incidence rate to be between 50% and 70%. 10,11 These formulations of tretinoin appeared to slow the absorption of tretinoin into the deeper layer of the skin or improve moisture preservation in the skin. 1,2 This study suggests that these conditions were protective against retinoid dermatitis.…”

Section: Discussionmentioning

confidence: 99%