Cited by 164Acne and Rosacea Treatments and EffectsDermatology and Skin DiseasesDermatologic Treatments and Research

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Why Topical Retinoids Are Mainstay of Therapy for Acne

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Leyden, James, Stein-Gold, Linda, Weiss, Jonathan·2017·Dermatology and Therapy

DOI 10.1007/s13555-017-0185-2PMC PMC5574737

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Abstract

Acne-focused dermatology expert groups have consistently recommended that most patients with acne be treated with a combination of topical retinoid and antimicrobial therapy. This is based on clinical data as well as evidence that these drug classes have different and complementary mechanisms of action that target multiple aspects of acne's complex pathophysiology. Recent evidence-based guidelines for acne, including those from the American Academy of Dermatology (AAD) and the European Dermatology Forum (EDF), have agreed that retinoids have an essential role in this widespread disease. The AAD states "retinoids are the core of topical therapy for acne because they are comedolytic, resolve the precursor microcomedone lesion, and are anti-inflammatory;" further, they "allow for maintenance of clearance." Despite uniform recommendation for use of topical retinoids, a recent study of prescribing practices from 2012 to 2014 indicated that dermatologists prescribed retinoids just 58.8% of the time while non-dermatologists prescribed them for only 32.4% of cases. In this article, we review the reasons supporting retinoids as the mainstay of acne therapy and discuss some of the perceived barriers that may be limiting use of this important drug class. Further, we discuss how and when titrating retinoid concentrations may be utilized in clinical practice. FUNDING: Galderma International.

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Fig. 1 Dose-dependent actions of adapalene at the molecular level. From Tenaud et al. [21]CC BY-NC · PubMed Central

Fig. 2 Dose-dependent clinical success rate (IGA) of 0.3 A/BPO, A/BPO, and vehicle in patients with severe acne at baseline. From Weiss et al. [68]CC BY-NC · PubMed Central

Fig. 3 Clinical efficacy of topical retinoid monotherapy on inflammatory lesions after 12 or 15 weeks therapy. From Leyden et al. [37]CC BY-NC · PubMed Central

Fig. 4 Changes over time in the skin with retinoid therapy, differentiating transient irritation versus inflammation. MoA mechanism of action, IL interleukin, TNF tumor necrosis factorCC BY-NC · PubMed Central

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Research works printed but not linked: 1

Ikoma ATJ, Bissonnette R, Gratton D, Kerrouche N. Enhancing tolerability to adapalene 0.1%/benzoyl peroxide 2.5% gel in acne patients: a randomized controlled trial of 4 different application regimens. Presented at 4th Eastern Asia Conference, Nov 16-18, 2016 Tokyo, Japan. 2016.

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Authors: Leyden, J., Stein-Gold, L., & Weiss, J.
Affiliations: University of Pennsylvania (US)
Gwinnett Dermatology (US)
Corresponding author: Leyden, James
Venue: Dermatology and Therapy
Publisher: Springer Science and Business Media LLC
Published: 2017-06-05
Volume: 7
Issue: 3
Pages: 293-304
ISSN: 2190-9172 (ISSN-L)
2193-8210
DOI: 10.1007/s13555-017-0185-2
PMC: PMC5574737
OpenAlex: W2621447419
Cited by: 164
References: 68
Citations by year: 2026: 14 · 2025: 20 · 2024: 22 · 2023: 21 · 2022: 20 · 2021: 20 · 2020: 23 · 2019: 15 · 2018: 6 · 2017: 2
FWCI: 2.25
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by-nc
Locations: Dermatology and Therapy (publishedVersion, cc-by-nc)
PubMed Central (publishedVersion, cc-by-nc)
PubMed (publishedVersion)
Funders: Galderma International
Topics: Health Sciences › Medicine › Dermatology › Acne and Rosacea Treatments and Effects
Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
Health Sciences › Medicine › Dermatology › Dermatologic Treatments and Research
Keywords: topical retinoids, acne, combination therapy, antimicrobial therapy, anti-inflammatory activity, acne pathophysiology, prescribing patterns

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Why Topical Retinoids Are Mainstay of Therapy for Acne

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