The DOI matches its Crossref record; 68 of the 68 references it cites were found in a registry or an index.
Why Topical Retinoids Are Mainstay of Therapy for Acne
Open accessAbstract
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]](/paper-figures/cb1f9a1c5ff54ee6b9fd0f951a50aab0/why-topical-retinoids-are-mainstay-of-therapy-for-acne-figure-1.jpg)
![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]](/paper-figures/da4979d6512241b699d2f92775667c70/why-topical-retinoids-are-mainstay-of-therapy-for-acne-figure-2.jpg)
![Fig. 3 Clinical efficacy of topical retinoid monotherapy on inflammatory lesions after 12 or 15 weeks therapy. From Leyden et al. [37]](/paper-figures/2e97830f37bf4729835b8d0b5ccdc338/why-topical-retinoids-are-mainstay-of-therapy-for-acne-figure-3.jpg)
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“ATRA, 9-cis-RA, and 13-cis-RA, which belong to the first generation of retinoids, are being gradually replaced in some applications by third-generation retinoids130.”
From Advances and challenges in retinoid delivery systems in regenerative and therapeutic medicine (2020) · cites this paper as [130]
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Guidelines of care for the management of acne vulgaris
Zaenglein, A. L., Pathy, A. L., Schlosser, B. J., Alikhan, A., Baldwin, H. E., Berson, D. S., Bowe, W. P., Graber, E. M., Harper, J. C., Kang, S., et al. (2016) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2015.12.037 · Cited by 1,597
Self-citationThiboutot, D. M., Gollnick, H. P. M., Bettoli, V., Dréno, B., Kang, S., Leyden, J. J., Shalita, A. R., Lozada, V. T., Berson, D. S., Finlay, A. Y., et al. (2009) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2009.01.019 · Cited by 863
Self-citationGollnick, H. P. M., Cunliffe, W. J., Berson, D. S., Dréno, B., Finlay, A. Y., Leyden, J. J., Shalita, A. R., & Thiboutot, D. M. (2003) · Journal of the American Academy of Dermatology · doi:10.1067/mjd.2003.618 · Cited by 818
Self-citationRetinoids in the treatment of skin aging: an overview of clinical efficacy and safety
Mukherjee, S., Date, A., Patravale, V., Korting, H. C., Roeder, A., & Weindl, G. (2006) · Clinical Interventions in Aging · doi:10.2147/ciia.2006.1.4.327 · Cited by 580
Guidelines of care for acne vulgaris management
Strauss, J. S., Krowchuk, D. P., Leyden, J. J., Lucky, A. W., Shalita, A. R., Siegfried, E. C., Thiboutot, D. M., Voorhees, A. S. V., Beutner, K. A., Sieck, C. K., et al. (2007) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2006.08.048 · Cited by 552
Self-citationInflammatory Events Are Involved in Acne Lesion Initiation
Jeremy, A. H. T., Holland, D. B., Roberts, S. G., Thomson, K. F., & Cunliffe, W. J. (2003) · Journal of Investigative Dermatology · doi:10.1046/j.1523-1747.2003.12321.x · Cited by 541
Acne Scars: Pathogenesis, Classification and Treatment
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European Evidence‐based (S3) Guidelines for the Treatment of Acne
Nast, A., Dréno, B., Bettoli, V., Degitz, K., ERDMANN, R., Finlay, A. Y., Gancevičienė, R., Hædersdal, M., Layton, A., López-Estebaranz, J. L., et al. (2012) · Journal of the European Academy of Dermatology and Venereology · doi:10.1111/j.1468-3083.2011.04374.x · Cited by 425
Vowels, B. R., Yang, S., & Leyden, J. J. (1995) · Infection and Immunity · doi:10.1128/iai.63.8.3158-3165.1995 · Cited by 331
Self-citationEvidence-Based Recommendations for the Diagnosis and Treatment of Pediatric Acne
Eichenfield, L. F., Krakowski, A. C., Piggott, C. D. S., Rosso, J. Q. D., Baldwin, H. E., Friedlander, S. F., Levy, M. L., Lucky, A. W., Mancini, A. J., Orlow, S. J., et al. (2013) · PEDIATRICS · doi:10.1542/peds.2013-0490b · Cited by 256
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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Polycystic Ovary Syndrome: Definition, Aetiology, Diagnosis and Treatment
Escobar-Morreale, H. F. (2018) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2018.24 · Cited by 2,083
Thiboutot, D. M., Dréno, B., Abanmi, A., Alexis, A. F., Araviiskaia, E., Cabal, M. I. B., Bettoli, V., Casintahan, F. A., Chow, S., COSTA, A. V., et al. (2017) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2017.09.078 · Cited by 418
Self-citationCurrent Issues in the Treatment of Acne Vulgaris
Habeshian, K. A., & COHEN, B. A. (2020) · PEDIATRICS · doi:10.1542/peds.2019-2056l · Cited by 180
Effects of Diet on Acne and Its Response to Treatment
Baldwin, H. E., & Tan, J. K. L. (2020) · American Journal of Clinical Dermatology · doi:10.1007/s40257-020-00542-y · Cited by 189
Advances and challenges in retinoid delivery systems in regenerative and therapeutic medicine
Ferreira, R., Napoli, J., Enver, T., Bernardino, L., & Ferreira, L. (2020) · Nature Communications · doi:10.1038/s41467-020-18042-2 · Cited by 138
Metadata
- Authors
- Leyden, J., Stein-Gold, L., & Weiss, J.
- Affiliations
- University of Pennsylvania (US)
- Gwinnett Dermatology (US)
- Corresponding author
- Leyden, James
- Venue
- Dermatology and Therapy
- Published
- 2017-06-05
- Volume
- 7
- Issue
- 3
- Pages
- 293-304
- ISSN
- 2190-9172 (ISSN-L)
- 2193-8210
- 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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