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Tretinoin: (Retin-A): Tretinoin works on acne by
normalizing the exfoliation of the follicular
epithelium, drains and promotes healing of existing
blemishes, and prevents new ones from forming.
Tretinoin also removes microorganisms that stimulate
inflammation."...Tretinoin may enhance penetration
of other drugs, such as topical antibiotics and
antimicrobials (Benzoyl Peroxide), by facilitating
the unplugged follicle to become less anaerobic and
more accessible. This inhibits the growth of P.
acnes and minimizes the rupturing of comedones into
surrounding tissue. As a results, Tretinoin is a
first line agent for both inflammatory and
non-inflammatory acne." - Cosmetic Dermatology April
1999 Side effects associated with Tretinoin are
peeling, redness, irritation, dryness, and increased
sun sensitivity. Topical Tretinoin, applied at acne
sites in small amounts does not alter plasma Vitamin
A levels, suggesting that it is a safe drug for use
during pregnancy.
Tretinoin formulas - Tretinoin is available in a
variety of formulations such as cream, gel, and
liquid. The selection of the formulation is
dependant upon skin type, skin condition, as well as
environment. More will be said later on on choosing
the right type for you. New developments in the
Tretinoin industry include the introduction of
generic formulations as well as a new microsphere
formulation. The new micorsphere formulation was
developed to help reduce irritation associated with
traditional Tretinoin. The formulation keep the
Tretinoin entrapped in a microsponge. Rather than
releasing the Tretinoin into the skin upon
application, the microsponges first attach to the
hair follicle, then release the drug. Improvements
are seen in as little as two weeks. Including the
benefit of decreased irritation, the micosphere
formulation was shown to reduce twice the number of
inflammatory and non-inflammatory lesions as the
regular formulation. The first generic version of
Retin-A®, known as Avita™, was approved by the FDA
in 1997. Both formulations contain the same active
ingredient, but the delivery system varies. While a
study was made that found the efficacy of the two
were comparable, there are some concerns with
generic substitutes. The main concern is when a
patient is started on the original product, then
decides to switch. Differences in innovator products
and generic products may lead to allergic reactions
(this is a concern in all products and not just
Tretinoin). Switching to a generic product can
result in an unsatisfactory result or treatment
failure.
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