INTRODUCTION
Efficacy and tolerability of topical treatments for acne and other dermatological conditions are impacted not only by the active drug but also by the vehicle used for its delivery.1,2 For example, drug distribution and absorption characteristics of a topical agent are largely impacted by the vehicle, which can also be formulated to increase skin hydration and decrease transepidermal water loss.3 Product attributes—such as moisturization, rapid absorption into the skin, non-greasiness, and ease of use—also strongly impact patient preference for, and subsequent adherence to, topical therapies.4-6 Further, these skin-sensation properties of topical therapeutics can impact patient quality of life, well-being, and self-esteem.7 Vehicle design and optimization of topical formulations are thus critical to the drug-development process and may profoundly influence patient use and treatment success.
Topical retinoids, including tretinoin, are a mainstay of acne treatment as they address multiple aspects of acne pathogenesis.3 However, tretinoin gel, cream, and foam formulations can be associated with significant cutaneous irritation and drying, which can lead to poor adherence.8,9 Traditional semisolid formulations can also leave a sticky and greasy feel on the skin, leading to poor patient adherence.10 To mitigate these issues, tretinoin 0.05% lotion (Altreno®, Ortho Dermatologics, Bridgewater, NJ) was formulated using a unique polymeric emulsion technology in an aesthetically pleasing vehicle.11 The lotion formulation incorporates a honeycomb matrix, allowing for efficient and uniform delivery of micronized tretinoin along with moisturizing/hydrating ingredients.11 The efficacy and tolerability of tretinoin 0.05% lotion were demonstrated in patients with moderate-to-severe acne, leading to its US approval in 2018 for the treatment of acne vulgaris in patients 9 years of age and older.12,13 Compared with studies of other tretinoin formulations, tretinoin 0.05% lotion has demonstrated lower rates of dryness, pain (ie, stinging, burning, or pain), erythema, and irritation11,12,14; however, lack of head-to-head trials makes direct comparisons difficult.
Topical retinoids, including tretinoin, are a mainstay of acne treatment as they address multiple aspects of acne pathogenesis.3 However, tretinoin gel, cream, and foam formulations can be associated with significant cutaneous irritation and drying, which can lead to poor adherence.8,9 Traditional semisolid formulations can also leave a sticky and greasy feel on the skin, leading to poor patient adherence.10 To mitigate these issues, tretinoin 0.05% lotion (Altreno®, Ortho Dermatologics, Bridgewater, NJ) was formulated using a unique polymeric emulsion technology in an aesthetically pleasing vehicle.11 The lotion formulation incorporates a honeycomb matrix, allowing for efficient and uniform delivery of micronized tretinoin along with moisturizing/hydrating ingredients.11 The efficacy and tolerability of tretinoin 0.05% lotion were demonstrated in patients with moderate-to-severe acne, leading to its US approval in 2018 for the treatment of acne vulgaris in patients 9 years of age and older.12,13 Compared with studies of other tretinoin formulations, tretinoin 0.05% lotion has demonstrated lower rates of dryness, pain (ie, stinging, burning, or pain), erythema, and irritation11,12,14; however, lack of head-to-head trials makes direct comparisons difficult.
