Retinoids: Best Solutions for Acne

In a study from 1988, retinoids were recognized as important treatments for acne, with varying results and side effects. Oral retinol at 90mg daily was given to 136 patients, resulting in 85% experiencing a significant reduction in inflammatory lesions within 3-4 months, but with side effects such as increased serum vitamin A and triglycerides, chelitis, dry skin, headaches, nosebleeds, hair loss, and abnormal liver function. Tretinoin, initially in an alcohol solution, caused irritation but later cream and gel formulations were better tolerated. Oral isotretinoin at 1 mg/kg/day was highly effective for severe acne types, despite serious side effects including teratogenicity and potential exacerbation of inflammatory bowel disease. Etretinate showed limited benefit for acne with similar toxicity to isotretinoin and was not recommended for acne treatment. Topical isotretinoin gel was effective for moderately severe acne with less irritation. The potential for new retinoid derivatives was noted, with the expectation that they would significantly impact dermatology.