Retin-A tretinoin (topical form of isotretinoin) is among acne modalities to get rid of breakouts especially when other forms of treatment has failed. Tretinoin is a prescribed drug and an skin irritant particularly in liquid form. Cold climates and exposure to sunlight may cause marked irritation. Retin-A (tretinoin) has an antikeratinization effect and prevents formation of the comedones. Retin-A differs from benzoyl peroxide and topical antibiotics in having no or a controversial effect on Porpionibacterium.acnes and causing no reduction in surface free fatty acids. Tretinoin effectiveness against microcomedones (a blackhead) compare with other removal modalities provides a rationale for its use in most forms of acne. This agent is particularly helpful in reducing non-inflammed lesions and comedones thereby indirectly reduces the number of inflammed blemishes by correcting the follicular hyperkeratosis. This drug is a powerful exfoliant and can cause tenderness, redness and scaling.

Tretinoins is used in treatment of mild to severe forms on comedonal (non-inflammatory acne). However, thery are also used to treat inflammatory acne in combination with other topical agents such as benzoyl peroxide and salicylic acid.

Retinoids are derived from Vitamin A. Retinoids could be found in alcohol form (retinol cream) or acid form ( retinoic acid- Retin-A cream). Unlike their close structures, retinol and retinoic acid seem to act very differently on epidermal tissue. Retinol by helping to restore the barrier function of the skin is very hydrating to the skin. On the contrary, retinoic acid is very drying and irritating to the skin. Interestingly, keratolytic effect of retinoic acid is different from that of retinol. Retinoic acid suchas Retin-A cream causes desquamation of skin tissue, so dead cells get separated more readily (smoother skin ). It also appear to help collagen synthesis (firmer skin and fewer wrinkles), as well as redistribution of melanin (skin pigment) by which even-tone the skin. Effect of a retinol cream on scar resurfacing sounds very limited.

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