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Features of photoaging include fine and coarse wrinkles, changes in skin pigmentation, and loss of elasticity. In human skin, topical retinoids increase collagen production, induce epidermal hyperplasia, and decrease keratinocyte and melanocyte atypia. Topical tretinoin is the most extensively investigated retinoid therapy for photoaging. [23]
Acitretin is a metabolite of etretinate, which was used prior to the introduction of acitretin. Etretinate was discontinued because it had a narrow therapeutic index as well as a long elimination half-life (t 1/2 = 120 days), making dosing difficult. In contrast, acitretin's half-life is approximately 2 days.
Tazarotene, sold under the brand name Tazorac, among others, is a third-generation prescription topical retinoid. [2] [3] It is primarily used for the treatment of plaque psoriasis and acne. [4] Tazarotene is also used as a therapeutic for photoaged and photodamaged skin. [4] It is a member of the acetylenic class of retinoids. [4]
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Isotretinoin is the only non-psychiatric drug on the FDA's top 10 list of drugs associated with depression [58] [63] and is also within the top 10 for suicide attempts. [64] A black box warning for suicide, depression, and psychosis has been present on isotretinoin's packaging in the United States since 2005. [63]
Adapalene Gel, sold in trade name Differin in China. Adapalene, sold under the brand name Differin among others, is a third-generation topical retinoid primarily used in the treatment of mild-moderate acne, and is also used off-label to treat keratosis pilaris as well as other skin conditions. [6]