Editorial: Retinoids — Dermatologists’ Drug of the Decade

    Frank C. Powell
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    TLDR Retinoids are important for treating skin conditions but should be used with caution due to serious side effects and risks during pregnancy.
    In the late 1970s, retinoids emerged as a significant advancement in dermatologic therapy, particularly for treating acne vulgaris and keratinization disorders. These synthetic analogues of Vitamin A were developed to offer the benefits of Vitamin A with fewer side effects. Isotretinoin, introduced in 1979, proved effective for severe cystic acne vulgaris, often leading to long-term remission after a 4-month course. However, isotretinoin's teratogenic potential raised serious concerns, leading to restrictions on its use among women of childbearing age unless they have severe, treatment-resistant acne. Despite precautions, there were reports of birth defects and spontaneous abortions when isotretinoin was used during pregnancy. The study mentioned in the editorial reported a case of congenital cardiac abnormality in an infant born to a patient treated with isotretinoin. The editorial emphasizes that isotretinoin should be prescribed only by acne treatment experts familiar with retinoids and their side effects, and its use should be limited due to the risks and high cost.
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