tretinoin topical (Retin A, Renova, Atralin, Avita, Refissa, Retin-A Micro, Tretin-X): Dosing and Uses

Dosing and uses of Retin A, Renova (tretinoin topical)

• Adult
• Pediatric

Adult dosage forms and strengths

topical cream

• 0.02% (Renova)
• 0.025% (Retin-A, Avita, Tretin-X)
• 0.0375% (Tretin-X)
• 0.05% (Retin-A, Renova, Refissa, Tretin-X)
• 0.075% (Tretin-X)
• 0.1% (Retin-A, Tretin-X)

topical geL

• 0.01% (Retin-A)
• 0.025% (Retin-A, Avita)
• 0.04% (Retin-A Micro)
• 0.05% (Atralin)
• 0.08% (Retin-A Micro)
• 0.1% (Retin-A Micro)

topical solution

• 0.05% (Retin-A)

Acne Vulgaris

Retin-A, Atralin, Avita, Retin-A Micro, Tretin-X

• Apply a pea-sized amount topically qHS to the skin where acne lesions appear, using enough to lightly cover the entire affected area
• Begin therapy with a low-concentration formulation (0.025% cream, 0.04% microsphere gel, or 0.01% gel); may use stronger preparations as tolerated

Facial Wrinkles

Adjunct for mitigation of fine wrinkles, mottled hyperpigmentation, and tactile roughness of facial skin

Renova, Refissa

• Apply a pea-sized amount (0.02-0.05%) to the affected area qHS

Administration

Apply 20 minutes after skin is cleansed and completely dried

Avoid lips and directly under eyes

Avoid UV exposure

Pediatric dosage forms and strengths

topical cream

• 0.02% (Renova)
• 0.025% (Retin-A, Avita, Tretin-X)
• 0.0375% (Tretin-X)
• 0.05% (Retin-A, Renova, Refissa, Tretin-X)
• 0.075% (Tretin-X)
• 0.1% (Retin-A, Tretin-X)

topical geL

• 0.01% (Retin-A)
• 0.025% (Retin-A, Avita)
• 0.04% (Retin-A Micro)
• 0.05% (Atralin)
• 0.08% (Retin-A Micro)
• 0.1% (Retin-A Micro)

topical solution

• 0.05% (Retin-A)

Acne Vulgaris

Retin-A, Atralin, Avita, Retin-A Micro, and Tretin-X

• <12 years old: Safety and efficacy not established
• ≥12 years old: Apply a pea-sized amount topically qHS to the skin where acne lesions appear, using enough to lightly cover the entire affected area
• Begin therapy with a low-concentration formulation (0.025% cream, 0.04% microsphere gel, or 0.01% gel); may use stronger preparations as tolerated

Administration

Apply 20 minutes after skin is cleansed and completely dried

Avoid lips and directly under eyes

Avoid UV exposure

Retin A, Renova (tretinoin topical) adverse (side) effects

Frequency not defined

Excessive dryness

Erythema

Scaling

Pruritus

Hyperpigmentation/hypopigmentation

Photosensitivity

Initial acne flare-up

Edema

Blistering

Stinging

Warnings

Contraindications

Hypersensitivity

Sunburn

Cautions

Extreme caution in eczema (may produce severe irritation of eczematous skin)

Discontinue if sensitivity or chemical irritation occurs

Exposure to UV light (including from sunlamps) increases intensity of inflammatory reaction

Concomitant topical medications such as abrasive soaps, cleansers, or cosmetics with strong drying effects may increase skin irritation

Pregnancy and lactation

Pregnancy category: C

Lactation: Not known whether excreted in breast milk

Pregnancy categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

Pharmacology of Retin A, Renova (tretinoin topical)

Mechanism of action

Inhibits microcomedo formation; decreases cohesiveness of keratinocytes in sebaceous follicles, which allows for easy removal; has anti-inflammatory properties

Absorption

MinimaL

Elimination

Excretion: Urine (0.1%)