Retinoid refers to a group of different active substances, which are collectively known as retinoids. All of these active ingredients are derivatives of vitamin A and have a positive effect on a wide variety of skin diseases. They can be used both externally and internally. However, they can also unfold severe side effects and are therefore contraindications in pregnancy and breastfeeding.
What is retinoid?
In general, retinoids help to treat various skin diseases and are extremely effective. As mentioned above, substances called retinoids are a whole group of vitamin A derivatives known collectively as retinoids. The first generation of retinoids are the non-aromatic retinoids. These include, for example, tretinoin, isotretinoin and alitretinoin. All of the first-generation retinoids also occur naturally in small amounts in vitamin A metabolism in humans. The second generation retinoids are mono-aromatic retinoids, for example acitretin, etretinate as well as motretinide. Finally, there is a third generation of retinoids, the poly-aromatic retinoids. These include adapalene, tazarotene, arotinoid, and the acetylene retinoids.
Pharmacologic action
It has not yet been possible to clarify exactly how retinoids achieve their effects. Some presumably bind to specific receptors and act in this way; for other retinoids, it is now known that they do not bind to receptors but are still effective. In general, retinoids help treat various skin conditions and are markedly effective, even when treating chronic skin conditions that are otherwise difficult to treat. However, the treatment of skin diseases with retinoids is not always free of side effects. Therefore, it must be carefully observed in each individual case whether the treatment is helpful for a person or rather harmful due to side effects. Since there are different retinoids, not every single one of these agents has to have the same effect. It must be weighed individually which of the retinoids may be helpful.
Medical application and use
The retinoid tretinoin is used to treat acute promyelocytic leukemia, acute myeloid leukemia, and acne and other hyperkeratotic skin diseases. Isotretionin is mainly used to treat acne, copper erysipelas, psoriasis and eczema. As an alternative to isotretionin, acetretin may also be used in the treatment of psoriasis. Motretinik is approved as a drug only in Switzerland, where it is used to treat acne as well as other hyperkeratotic skin conditions. Adapalene, a third-generation retinoid, is approved in many countries and is used primarily for the treatment of acne. In North America, Australia and Europe, this active ingredient is approved as a drug. Furthermore, there are many other retinoids and many more currently in the development and research phase.
Risks and side effects
As mentioned above, while retinoids are often effective and helpful, they are unfortunately not free of side effects, some of which are sensitive. These include increased sensitivity to light and the associated greater risk of sunburn, itching, burning, stinging, and other skin irritations. Redness of the skin may also occur. In the case of hyperpigmented skin, the use of retinoids often results in lightening of the treated areas of skin. In general, the side effects that can occur during treatment with retinoids vary from retinoid to retinoid and from person to person. It is therefore very important to always remain in close contact with the treating physician during treatment in order to be able to decide in individual cases what to do if side effects occur. Possibly a change of the remedy can be helpful in case of complaints, since the mentioned side effects do not occur in every person with every retinoid, but other retinoids can be used with luck without side effects. In principle, women must not be treated with retinoids during pregnancy and while breastfeeding. It is therefore forbidden to prescribe medications containing retinoids to pregnant and nursing mothers.
