Tretinoin (Chinese transliteration: All-Trans Retinoic Acid) is a medication derived from vitamin A, primarily used to treat skin conditions and certain hematologic diseases. This drug regulates cell growth cycles, promotes epidermal renewal, and has anti-inflammatory effects. In dermatology, it is widely applied in the treatment of moderate to severe acne, skin texture irregularities caused by photoaging, and a few non-fungal xerosis conditions.
In hematologic disease treatment, Tretinoin is mainly used for the treatment of acute promyelocytic leukemia (APL), where it induces leukemia cell differentiation and inhibits malignant proliferation. Its mechanism of action is closely related to regulating gene expression and cell differentiation pathways, thus offering multifaceted therapeutic value in clinical applications.
The scientific name of this drug is Tretinoin. Common topical formulations include:
Oral forms of Tretinoin are usually supplied as generics, but it is important to note that different formulations may have varying contraindications and dosage guidelines.
Tretinoin belongs to the class of "Retinoids," which have properties that regulate epidermal differentiation, inhibit keratinization, and possess anti-inflammatory effects. Topical forms are classified as dermatological agents other than corticosteroids, while oral forms are categorized as anti-leukemia drugs.
Based on its mechanism of action, it can also be classified as a "Differentiation Inducer," as it can induce malignant cells to restore normal differentiation functions, giving it a unique position in the treatment of hematologic diseases.
1. Topical treatment of moderate to severe acne (acne vulgaris)
2. Improvement of skin texture and fine lines caused by photoaging
3. Relief of symptoms in non-fungal xerosis (Ichthyosis)
4. Induction of remission and maintenance therapy in acute promyelocytic leukemia (APL)
The choice of formulation and dosage depends on the specific indication. For acne treatment, topical creams with concentrations of 0.025%-0.1% are commonly used at night, while high-dose oral therapy is required for hematologic diseases.
Emergency Side Effects include: difficulty breathing, acute liver failure, severe allergic reactions (such as urticaria, facial swelling). Immediate medical attention is required if these symptoms occur.
Concurrent use with other retinoids can exacerbate side effects. For example, combining with isotretinoin may lead to toxicity accumulation. When used with tetracycline antibiotics, liver function monitoring is advised.
Using with anticoagulants (such as warfarin) may enhance anticoagulant effects, requiring dose adjustments. Topically, avoid combining with irritants like alpha hydroxy acids or benzoyl peroxide, as this may increase skin irritation.
Topical formulations are typically used as creams or gels with concentrations of 0.025%-0.1%. For acne, apply a thin layer at night before sleep. For photoaging, lower concentrations and adjusted frequency may be used.
In acute leukemia, oral doses are calculated based on body weight, with induction remission doses often ranging from 44-60 mg/m²/day, administered in divided doses. Strict adherence to medical instructions is essential; do not adjust doses independently.
If a topical dose is missed, apply immediately upon discovery. If close to the next scheduled dose, skip the missed dose and resume normal use the following day. Do not double doses to compensate.
For oral doses, if missed and less than 3 hours have passed, take immediately; if more than 3 hours, skip the dose. Do not increase the total daily dose due to missed doses. Contact your healthcare provider for further guidance.
Topical overdose may cause severe skin irritation; wash the area thoroughly with soap and water and apply cold compresses to relieve redness and swelling. Systemic symptoms such as nausea or vomiting require immediate medical attention.
Oral overdose can lead to acute liver damage or hypocalcemia. Immediate medical intervention includes gastric lavage, activated charcoal administration, and supportive care. Monitoring of liver enzymes, electrolytes, and coagulation parameters is necessary during treatment.
When using tretinoin cream with other topical medications, how should I arrange the application order?
It is recommended to apply tretinoin last, with a 30 to 60-minute interval after applying other topical medications (such as benzoyl peroxide or antibiotics). This reduces skin irritation and ensures optimal absorption of each medication. If multiple medications are used concurrently, consult a healthcare professional for a personalized schedule.
Tretinoin may cause skin peeling or redness. How can I alleviate these symptoms?
Mild peeling or redness are common reactions. Adjust by reducing application frequency (e.g., every other day) or decreasing the area applied. Severe symptoms can be managed with soothing, non-alcoholic moisturizers and consulting a healthcare professional for dose adjustment. Avoid scratching the affected area to prevent infection.
What precautions should I take for sun protection during tretinoin use?
Tretinoin increases skin sensitivity to ultraviolet rays. Use a broad-spectrum sunscreen with SPF 30 or higher daily, along with physical barriers such as hats and masks. Avoid direct sunlight when outdoors, even on cloudy days or in winter, and follow strict sun protection measures.
Does long-term use of tretinoin cause skin problems to rebound after stopping?
Some patients may experience a "rebound phenomenon," where skin issues temporarily worsen after discontinuation. It is common. Gradually reduce the dose under medical supervision rather than stopping abruptly, and continue monitoring skin condition. The healthcare provider may suggest switching to other retinoids or adjusting the treatment plan to prevent rebound effects.
Can I use tretinoin if I am breastfeeding or planning to become pregnant?
Oral tretinoin (such as isotretinoin) poses teratogenic risks and is strictly prohibited during pregnancy. Topical tretinoin has a lower risk, but women of reproductive age should use effective contraception during treatment. Use during breastfeeding should be evaluated by a healthcare professional; some studies suggest topical forms carry minimal risk, but individual assessment is necessary.
%201.svg)
Copyright © 2025 MedFrontiers. All Rights Reserved.
