40 Years of Topical Tretinoin Use in Review

June 2013 | Volume 12 | Issue 6 | Original Article | 638 | Copyright © June 2013

Hilary E. Baldwin MD,a Marge Nighland BS,b Clare Kendall MA,c David A. Mays PharmD MBA,c Rachel Grossman MD,b,c and Joan Newburger PhDc

aSUNY Downstate Medical Center, Brooklyn, NY bValeant Dermatology, a subsidiary of Valeant Pharmaceuticals North America LLC, Bridgewater, NJ cJohnson & Johnson Consumer & Personal Products Worldwide, Skillman, NJ

histological improvement compared with vehicle.137 Topical tretinoin has been shown to increase viable epidermal thickness and create a more undulating dermoepidermal junction with prominent rete ridges, as well as effecting other dermal changes such as increased glycosaminoglycan deposition and elastic fibers and the formation of new blood vessels.137

Multiple Miliary Osteoma Cutis

A case study suggests that topical tretinoin 0.05% may decrease the number and size of papules after 3 months of treatment.138


Currently, tretinoin is approved by FDA to treat AV and photodamage. However, through 40 years of research and clinical use, topical tretinoin has also been shown to be safe and effective in treating a range of other diseases and conditions, both as monotherapy and in combination with other agents. These conditions include skin and pigmentation disorders, lesions of the oral mucosa and the ocular surface epithelia, hypertrophic scarring, and various infections. Although topical tretinoin is associated with a number of application-site AEs, newer formulations and modes of application have been shown to reduce irritation potential.
The list of diseases for which the effectiveness of topical tretinoin has been evaluated is remarkably diverse. This is, in part, a testament to the complexities of retinoid biology and the protean consequences and advantages of interacting with retinoid receptors. Some clinical uses of tretinoin appear to take advantage of its keratolytic action, allowing increased penetration of medications with which it is coapplied, thus improving their efficacy.
Although it is difficult to imagine adding to the multitude of conditions listed here, additional uses of topical tretinoin will no doubt be reported in the future. In our continuing efforts to provide advice on evidence-based medicine for our patients and to provide rationale for managed care companies, we look forward to additional clinical trials to further elucidate the beneficial effects of tretinoin on the skin. Such studies will undoubtedly also help us in our efforts to better understand the complex interactions of retinoids in the human body.
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