<p>Momlive—if you have a history of rosacea, be very cautious with Retin-A. I do not think dermatologists are currently recommending its usage in your case. </p>
<p>"Many anti-acne products are known to worsen rosacea symptoms. Medical experts strongly urge rosacea sufferers to stop using these products. There are several classes of topical prescription medications that rosacea sufferers should not use because the risks far out way their benefits.</p>
<p>II. Topical Retinoids (Tretinoin)</p>
<p>Topical retinoids such as retinoic acid and Vitamin A derivatives are used for the treatment of acne. Many general dermatologists also use topical retinoids to treat rosacea papules and pustules. There is mounting evidence indicating that topical retinoids such as tretinoin should not be used for treating rosacea papules or pustules because they make the underlying vascular disease worse. In a recent medical review, “Rosacea: Pathophysiology and Treatment”, Dr. Jonathan Wilkin discusses numerous reasons why rosacea patients should not use topical retinoids such as tretinoin: (114)</p>
<pre><code>* He states, “Tretinoin may provoke severe erythema in patients with rosacea.”
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He further cautions that with tretinoin therapy, “Flushing reactions will have a more intense redness, and there will be an enhancement of the inflammatory process.”
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Dr. Wilkin stresses, “Irritation from the tretinoin may directly exacerbate the underlying inflammatory reaction.”
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He also warns, “Tretinoin may cause angiogenesis in the rosacea distribution. The tretinoin-induced erythema may mask the worsening angiogenesis and telangiectasia. I have seen several patients who have bright red faces during treatment with topical tretinoin.”
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He ends his discussion on tretinoin by stating, “Since rosacea appears to be in its most fundamental elements a vascular disorder, it would be wise to first do no harm.”
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<p>III. Caution on Other Topical Retinoids and Retinoid-Like Compounds</p>
<p>Due to their irritant qualities, extreme caution must be given to all topical forms of retinoic acid and vitamin A derivatives. Newer formulations have been developed to lessen the potential for irritation; however, these are still too harsh for many rosacea sufferers. Below are a few quotes on the irritant qualities of these newer formulations:</p>
<pre><code>* Retin-A Micro(tretinoin gel, Ortho Pharma-ceutical Corporation): Although this newer gel was designed to be less irritating, Retin-A Micro is still irritating to sensitive skin. The Physicians’ Desk Reference (2000) warns, “The skin of certain individuals may become excessively dry, red, swollen, or blistered,” and that, “A transitory feeling of warmth or slight stinging may be noted on application”. Additionally, it is warned that, “Weather extremes, such as wind or cold, may be irritating to patients being treated with tretinoin”.
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Avita (tretinoin gel, DPT Laboratories): The Physicians’ Desk Reference (2000) warns that, “The skin of certain individuals may become excessively red, edematous, blistered, or crusted”, and that, “Application may cause a transient feeling of warmth or slight stinging”. Additionally, it is warned, “Some patients also notice that their skin begins to take on a blush”.
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Differin (adapalene gel, Galderma Labor-atories, Inc.): The Physicians’ Desk Reference (2000) warns that during treatment with this retinoid-like gel, “Some adverse effects such as erythema, scaling, dryness, pruritus, and burning will occur in 10-40% of patients”, and that, “Weather extremes, such as wind or cold, may be irritating to patients under treatment with adapalene”. "
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