Retinoid medicines are available as products that can be spread on the skin (gels, creams, or ointments) and as pills or capsules. Retinoid gels are usually applied once a day. Retinoid pills are
usually taken either every other day or every day.
Retinoids may be combined at low doses with other treatments, such
as psoralen and ultraviolet A light therapy (PUVA), steroid creams or
ultraviolet B (UVB) light exposure, and tar
It is not well understood how retinoids work to treat
psoriasis. They help slow the growth and shedding of
Retinoids are used to treat
erythroderma or pustular psoriasis. Topical medicines
that you spread on affected areas of the skin are used for mild to moderate
psoriasis. Oral medicines that you take as pills or capsules are used to treat
severe psoriasis that is resistant to other therapies. As symptoms improve, the
dose may be reduced and other medicines may be used for treatment.
Retinoids should not be used by women who are pregnant or who are
planning to become pregnant within 3 years after stopping retinoid
treatment. The medicines are
teratogens, which means they can cause birth defects
In general, these medicines are not used alone. If used alone, it
may take several months to see any improvement. The condition may even get
worse during the first few weeks of therapy. Tazarotene can cause a severe
local irritation if it is used alone. It is much less irritating to the skin if it is
used with a
corticosteroid. A retinoid
combined with a corticosteroid is more effective in reducing symptoms and prolonging
remission (period of no symptoms) than when corticosteroids are used alone.1, 2
Retinoids can improve the outcome of PUVA and UVB
Topical retinoids are safer than oral retinoid medicines.
Side effects of retinoid gels include:
Side effects of retinoid pills include:
See Drug Reference for a full list of side effects. (Drug Reference
is not available in all systems.)
You will need to have blood tests on a regular schedule while you
are taking this drug.
Because of severe side effects, acitretin (Soriatane) should be
prescribed only by doctors who are familiar with the use of this kind of
medicine—such as a
dermatologist. Some doctors believe there
are too many risks in using this medicine.
Women who are pregnant or may become pregnant should not take
isotretinoin because of the risk of serious side effects such as miscarriage
and birth defects. The U.S. Food and Drug Administration (FDA) requires
companies that make isotretinoin to have a program to register doctors who
prescribe isotretinoin and the people who take isotretinoin. The program tries
to ensure that people taking this medicine understand the risk of birth
defects, take precautions to avoid pregnancy, and know what to do if they
become pregnant. If your doctor suggests that you take isotretinoin, you must
register with iPLEDGE to get the medicine. You can get more information and
register at www.ipledgeprogram.com or by telephone (toll-free) at
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
CitationsNaldi L, Rzany B (2009). Psoriasis (chronic plaque),
search date August 2007. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.Mason AR, et al. (2009). Topical treatments for chronic plaque psoriasis. Cochrane Database of Systematic Reviews (2).
January 9, 2012
Adam Husney, MD - Family Medicine & Amy McMichael, MD - Dermatology
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