Short contact therapy of acne with tretinoin

Abstract

The most frequent side effect of topical retinoids is irritant contact dermatitis. It occurs in approximately 85% of patients; the percentage can reach up to 95% in patients treated with tretinoin. Severity of this dermatitis is moderate to severe in approximately 20% of patients. However, 15% of patients stop the treatment with tretinoin because of skin irritation. The authors used tretinoin as short contact therapy (SCT) in mild to moderate acne, in order to try to reduce the incidence and severity of irritant contact dermatitis. They present the final results of a sponsor-free, pilot, open, multicenter study. Seventy-four patients were treated with 0.05% tretinoin cream. It was applied once daily for 30 min. Treatment duration ranged from 8 to 32 weeks (mean duration: 12 weeks). Acne severity and treatment efficacy were evaluated by means of the Global Acne Grading System. A significant clinical improvement (≥50% from baseline) was observed in 41 patients (55.4%). Thirteen patients (17.6%) developed a mild skin irritation. Four patients (5.4%) stopped the treatment because of severe skin irritation. Efficacy of tretinoin used as SCT seems to be superimposable to that of tretinoin used according to standard modality. Tolerability of SCT with tretinoin is very good. This tolerability allows a high adherence of patients to the treatment and it markedly improves compliance.

Allergic contact dermatitis caused by topical antiacne drugs

“…This dermatitis is characterized clinically by dryness, peeling, scaling, erythema, edema, stinging, burning and itching. Dryness, peeling, erythema, stinging and burning are the most frequent side effects, whereas scaling, itching and edema are rare [2,3]. RD is very common, occurring, in our experience, in approximately 85% of patients [2,3]; the percentage can reach up to 95% in patients treated with tretinoin [2,3].…”

“…RD is very common, occurring, in our experience, in approximately 85% of patients [2,3]; the percentage can reach up to 95% in patients treated with tretinoin [2,3]. RD would be more frequent in patients with a low phototype [2,3]. RD usually appears after the first application of the retinoid; very rarely, it persists for the entire duration of the treatment [2,3].…”

“…Length is changeable, from a few days up to 3 weeks. In our experience, severity of tretinoin-induced ICD is moderate to severe in approximately 20% of patients [2,3]. Furthermore, it was found in our experience that 15% of patients stop the treatment because of skin irritation [2,3].…”

“…Severity of RD mainly depends on the type of retinoid: tretinoin and tazarotene can be highly irritant, while retinol and retinaldehyde are not irritants [4]. RD severity is also concentration-dependent and vehicle-dependent: retinoids in alcoholic gel or lotion are more irritant [1,3]. Severity of RD is usually mild to moderate.…”

“…RD would be more frequent in patients with a low phototype [2,3]. RD usually appears after the first application of the retinoid; very rarely, it persists for the entire duration of the treatment [2,3]. Severity of RD mainly depends on the type of retinoid: tretinoin and tazarotene can be highly irritant, while retinol and retinaldehyde are not irritants [4].…”