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Oral 
retinoids
• retinoids are a class of chemical compounds that are related 
chemically to vitamin A. 
Retinoids (found in animal foods) 
Carotenoids (found in plant foods) 
• Retinoids are used in medicine, primarily due to the way they 
regulate epithelial cell growth.
Types 
3generations of retinoids: 
• First generation retinoids: retinol, retinal, tretinoin (retinoic acid, 
Retin-A), isotretinoin, and alitretinoin. 
• Second generation retinoids: etretinate and its 
metabolite acitretin. 
• Third generation 
retinoids: tazarotene, bexarotene and Adapalene.
Function of retinoid 
roles in vision 
 regulation of cell proliferation and 
differentiation, growth of bone tissue, 
 immune function, and 
activation of tumor suppressor genes. 
Research is also being done into their ability to treat skin cancers
Skin condition use 
acne 
 psoriasis 
wrinkles 
age spots
Action 
• Retinoids work to reduce the amount of oil secreted through the 
glands lessen SEBUM production. 
• reduce the hypercornification (the excessive production of skin 
cells in the lining of the follicle) of the pilosebaceous duct. 
• do not have any antibacterial properties but appear to lessen the 
bacterial population 
• Retinoids lessen the inflammation on the plugs in the skin pores. 
(These plugs are dead skin cells mixture, bacteria and sebum) 
• Regular blood tests to check on liver function are very common.
Side Effects 
• dry skin 
• occasionally nosebleeds as a result of dry nasal mucosa. 
• first month or so, oral retinoids may cause a temporary flare up of acne 
conditions 
• Liver damage many doctors will recommend blood samples to be taken 
and examined before and during oral retinoid treatment. 
• depression but no medical literature has agreed as to the risk. 
• cause birth defects if women take the medicine while pregnant or on the 
drug when they become pregnant must use two effective methods of 
birth control.
precautions 
• Do not apply astrin¬gents, 
• drying agents, 
• abrasive scrubs, or harsh soaps to your face while using the 
retinoid. 
• Retinoids may make you more sensitive to sunlight. Apply a 
sunblock to your face before spend¬ing time in the sun.
Adapalene - Differin, is a synthetic topical retinoid 
• acne and other skin-related diseases. 
• Adapalene works by helping unclog blocked skin pores, and 
providing mild anti-inflammatory properties.
Tazarotene-Tazorac or Avage 
synthetic topical retinoid 
• help keep acne-prone follicles on the skin free of comedone plugs 
(blackheads and whiteheads) 
• used to fight off the accelerated signs of aging due to unprotected 
exposure to the sun (photoaging).
Tretinoin-Retin-A and Renova, is a topical retinoid 
• unclog skin follicles affected by acne. 
• The drug can also be used to reduce the signs of photoaging, such 
as wrinkles and age spots.
Acitretin – Soriatane (oral retinoid) 
• primarily used to treat Darier's disease and psoriasis, 
• chemoprevention of skin cancer with transplant patients, 
according to the Skin Cancer Foundation.
Isotretinoin 
(trade name: Accutane) 
• most potent retinoids available on the market, 
• treatment of only the most severe cases of acne, such as acne 
cysts and nodul Isotretinoin 
• addresses all the major causes of acne, including inflammation, 
bacterial infection, sebum oil production and blocked pores.
ISOTRETINOIN: 
• Isotretinoin is unique in that it controls acne for months, years, or 
permanently after the end of treatment. 
• Four to five months of isotretinoin treatment usually lead to 
clearing of acne for 1 year or more after the medicine is stopped. 
• All other internal acne-controlling medicines are antibacterial 
agents, which are effective only while they are used. 
• Isotretinoin is not only considered the only known possible cure of 
acne in some patients, but was originally a chemotherapy 
treatment for certain cancers, such as leukemia
HOW DOES ISOTRETINOIN WORK? 
• Isotretinoin decreases the amount of oil produced by the skin’s 
sebaceous (oil) glands. 
• It may be as long as 3 months before you see improvement in your 
skin. 
• There is no medicine we can add to speed isotretinoin’s action.
TREATMENT 
• Isotretinoin works best when taken with food, so remember to 
take it at mealtime.
interaction 
• Do not take vitamin A while being treated with isotretinoin; 
serious side effects may occur. Isotretinoin and vitamin A are 
closely related chemically. You should also stop any other acne 
treatment by mouth because antibiotics may interact with 
isotretinoin. You may continue to apply medicine to your face if 
you wish, but do not use tretinoin (Retin-A and other brands) while 
being treated with isotretinoin. 
• Occasionally acne gets worse during the first month or two of 
treatmentside effects such as lip dryness begin before the acne 
starts to clear.
Side effects 
• Isotretinoin is expensive and has many annoying side effects 
• Isotretinoin comes with potentially serious fetal side effects if 
used or directly handled by pregnant womens. 
• Except for birth defects isotretinoin is remarkably safe. Even 
massive overdoses cause only dry skin and headaches. 
• .
• Isotretinoin may increase the level of triglycerides (fats) in the 
blood. Rarely, it may affect liver function. 
• establish baseline blood chemistries before patients begin to take 
isotretinoin. 
• After 4 to 6 weeks of isotretinoin treatment, the blood chemistry 
tests are repeated. If these tests are normal, further testing is not 
necessary. 
• Depression is a rare side effect
precautions 
• . During isotretinoin treatment, skin may be more easily injured 
vigorous physical exercise should be avoided. 
• Consequently, defer wax-type hair removal and any facial 
cosmetic surgery or resurfacing procedure.
LONG-TERM RESULTS 
• Isotretinoin is not a permanent cure for acne, although it often 
clears acne until nature clears your skin. 
• One year after completion of a course of isotretinoin, four out of 
five persons will be free of acne. 
• Three years after isotretinoin treatment, about three out of five 
persons will remain without acne. 
• Should it become necessary, it is safe to take a second or a third 
course of isotretinoin, or take a short booster course of 
isotretinoin.
dosage 
 India as 5, 10, 20, 30, and 40 mg sofgel capsules 
 0.5-1.0 mg/kg body weight 
 The treatment is continued till a cumulative dose of 120-150 mg/kg has been achieved. 
 This typically may take 6-8 months.
Retinoids - Chennai Plastic Surgery

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Retinoids - Chennai Plastic Surgery

  • 2. • retinoids are a class of chemical compounds that are related chemically to vitamin A. Retinoids (found in animal foods) Carotenoids (found in plant foods) • Retinoids are used in medicine, primarily due to the way they regulate epithelial cell growth.
  • 3. Types 3generations of retinoids: • First generation retinoids: retinol, retinal, tretinoin (retinoic acid, Retin-A), isotretinoin, and alitretinoin. • Second generation retinoids: etretinate and its metabolite acitretin. • Third generation retinoids: tazarotene, bexarotene and Adapalene.
  • 4. Function of retinoid roles in vision  regulation of cell proliferation and differentiation, growth of bone tissue,  immune function, and activation of tumor suppressor genes. Research is also being done into their ability to treat skin cancers
  • 5. Skin condition use acne  psoriasis wrinkles age spots
  • 6. Action • Retinoids work to reduce the amount of oil secreted through the glands lessen SEBUM production. • reduce the hypercornification (the excessive production of skin cells in the lining of the follicle) of the pilosebaceous duct. • do not have any antibacterial properties but appear to lessen the bacterial population • Retinoids lessen the inflammation on the plugs in the skin pores. (These plugs are dead skin cells mixture, bacteria and sebum) • Regular blood tests to check on liver function are very common.
  • 7. Side Effects • dry skin • occasionally nosebleeds as a result of dry nasal mucosa. • first month or so, oral retinoids may cause a temporary flare up of acne conditions • Liver damage many doctors will recommend blood samples to be taken and examined before and during oral retinoid treatment. • depression but no medical literature has agreed as to the risk. • cause birth defects if women take the medicine while pregnant or on the drug when they become pregnant must use two effective methods of birth control.
  • 8. precautions • Do not apply astrin¬gents, • drying agents, • abrasive scrubs, or harsh soaps to your face while using the retinoid. • Retinoids may make you more sensitive to sunlight. Apply a sunblock to your face before spend¬ing time in the sun.
  • 9. Adapalene - Differin, is a synthetic topical retinoid • acne and other skin-related diseases. • Adapalene works by helping unclog blocked skin pores, and providing mild anti-inflammatory properties.
  • 10. Tazarotene-Tazorac or Avage synthetic topical retinoid • help keep acne-prone follicles on the skin free of comedone plugs (blackheads and whiteheads) • used to fight off the accelerated signs of aging due to unprotected exposure to the sun (photoaging).
  • 11. Tretinoin-Retin-A and Renova, is a topical retinoid • unclog skin follicles affected by acne. • The drug can also be used to reduce the signs of photoaging, such as wrinkles and age spots.
  • 12. Acitretin – Soriatane (oral retinoid) • primarily used to treat Darier's disease and psoriasis, • chemoprevention of skin cancer with transplant patients, according to the Skin Cancer Foundation.
  • 13. Isotretinoin (trade name: Accutane) • most potent retinoids available on the market, • treatment of only the most severe cases of acne, such as acne cysts and nodul Isotretinoin • addresses all the major causes of acne, including inflammation, bacterial infection, sebum oil production and blocked pores.
  • 14. ISOTRETINOIN: • Isotretinoin is unique in that it controls acne for months, years, or permanently after the end of treatment. • Four to five months of isotretinoin treatment usually lead to clearing of acne for 1 year or more after the medicine is stopped. • All other internal acne-controlling medicines are antibacterial agents, which are effective only while they are used. • Isotretinoin is not only considered the only known possible cure of acne in some patients, but was originally a chemotherapy treatment for certain cancers, such as leukemia
  • 15. HOW DOES ISOTRETINOIN WORK? • Isotretinoin decreases the amount of oil produced by the skin’s sebaceous (oil) glands. • It may be as long as 3 months before you see improvement in your skin. • There is no medicine we can add to speed isotretinoin’s action.
  • 16. TREATMENT • Isotretinoin works best when taken with food, so remember to take it at mealtime.
  • 17. interaction • Do not take vitamin A while being treated with isotretinoin; serious side effects may occur. Isotretinoin and vitamin A are closely related chemically. You should also stop any other acne treatment by mouth because antibiotics may interact with isotretinoin. You may continue to apply medicine to your face if you wish, but do not use tretinoin (Retin-A and other brands) while being treated with isotretinoin. • Occasionally acne gets worse during the first month or two of treatmentside effects such as lip dryness begin before the acne starts to clear.
  • 18. Side effects • Isotretinoin is expensive and has many annoying side effects • Isotretinoin comes with potentially serious fetal side effects if used or directly handled by pregnant womens. • Except for birth defects isotretinoin is remarkably safe. Even massive overdoses cause only dry skin and headaches. • .
  • 19. • Isotretinoin may increase the level of triglycerides (fats) in the blood. Rarely, it may affect liver function. • establish baseline blood chemistries before patients begin to take isotretinoin. • After 4 to 6 weeks of isotretinoin treatment, the blood chemistry tests are repeated. If these tests are normal, further testing is not necessary. • Depression is a rare side effect
  • 20. precautions • . During isotretinoin treatment, skin may be more easily injured vigorous physical exercise should be avoided. • Consequently, defer wax-type hair removal and any facial cosmetic surgery or resurfacing procedure.
  • 21. LONG-TERM RESULTS • Isotretinoin is not a permanent cure for acne, although it often clears acne until nature clears your skin. • One year after completion of a course of isotretinoin, four out of five persons will be free of acne. • Three years after isotretinoin treatment, about three out of five persons will remain without acne. • Should it become necessary, it is safe to take a second or a third course of isotretinoin, or take a short booster course of isotretinoin.
  • 22. dosage  India as 5, 10, 20, 30, and 40 mg sofgel capsules  0.5-1.0 mg/kg body weight  The treatment is continued till a cumulative dose of 120-150 mg/kg has been achieved.  This typically may take 6-8 months.