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Tretinoin (Retin-A®) and Tazarotene (Tazorac®) Therapy

Tretinoin (Retin-A®) and Tazarotene (Tazorac®) are retinoids that work extremely well in the prevention of comedones responsible for acne formation. Both of these are prescription medications that are core components of most acne regimens.

Tretinoin (Retin-A®) should initially be applied in a pea-sized amount for the entire face. The pea-sized amount is placed on the finger tip, dabbed in different areas of the face, and then rubbed into the skin. It should initially be applied every other night in order to determine tolerance to the drying effects of the medication. If every other night application does not cause drying, then it may be safe to use the medication every night. The medication is applied at night because sunlight deactivates the molecule making morning application less effective.

Tazarotene (Tazorac®) is a very strong and irritating retinoid used for both acne and psoriasis. This retinoid is extremely effective, but must be used cautiously since the drying side effect can be quite uncomfortable. Tazarotene may be started by applying a pea-sized amount to the entire face (as described above) for 5 minutes and then washing it off. This should be done every other night and then increased to every night if tolerated. Once 5 minutes of contact every other night is deemed to be non-irritating, the time may be increased to 10 minutes and then washed off. Likewise, the contact time may be methodically increased per week to 20 minutes, 30 minutes, 1 hour, and then overnight should no irritation occur.

Both of these agents have been used as anti-aging creams as well (Renova® and Avage®). These creams were formulated to be somewhat less irritating. A prescription will be needed for either of these medications.

In summary:

Tretinoin / Retin-A® / Retin-A Micro®

  • place a pea-sized amount on the tip of your finger, dab small areas on your entire face, and then rub the medication in
  • this medication should be applied every other night for one to two weeks; if tolerated without dryness, cracking, or irritation, then you may apply this medication every night
  • if your skin becomes red, dry, scaly, or irritated, then take a day or two off in between applications
  • this medication will be deactivated by sunlight, thus it is primarily applied at night

Tazorac®

  • place a pea-sized amount on the tip of your finger, dab small areas on your entire face, and then rub the medication in
  • this medication should be applied for 5 minutes and then washed off every other night for the first week; then, 10 minutes every other night for the second week, 20 minutes every other night for the third week, 1 hour every other night for the fourth week, then all night every other night for the fifth week, then all night every night thereafter
  • if your skin becomes red, dry, scaly, or irritated, then take a day or two off in between applications
  • this medication is not made to use twice a day since it is quite irritating

Don Mehrabi MD, FAAD
Dermatologist, Certified by the American Board of Dermatology
Los Angeles, California

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