Increased Retinoid Therapy for Acne

[Guide]

A recently published paper concluded, "Expert groups and evidence-based guidelines agree that topical retinoids should be considered the foundation of acne therapy." So this article explains the increased use of retinoids by physicians over antibiotics since there is concern over antibiotic resistance. This article states, "The use of retinoids plus BPO targets multiple pathways and can often eliminate the need for antibiotics, reducing the likelihood of antibiotic resistance."

Isotretinoin is just one of the several retinoids used to treat acne. The retinoids mentioned in the article are, "adapalene 0.1% and 0.3%; tazarotene 0.1%; tretinoin 0.01%, 0.025%, 0.038%, 0.04%, 0.05%, 0.08%, and 0.1% in the USA; isotretinoin 0.05% and 0.1% in other regions of the world" and reviews "the evidence supporting why retinoids should be considered the foundation of acne therapy (with a focus on topical retinoids)."

The article states, "Both dermatologists and other physicians were less likely to prescribe a retinoid for patients aged 19 or older compared to those aged 10–19."

The topical retinoids mentioned in this article are a "fixed combination adapalene 0.3%-benzoyl peroxide (BPO) 2.5% (0.3 A/BPO; Epiduo Forte®, Galderma Laboratories) and topical retinoids (adapalene, tazarotene, or tretinoin) and Retinoids are also available in fixed-combination formulations with BPO [adapalene-BPO 0.1%/2.5% and 0.3%/2.5% (Epiduo® and Epiduo Forte®, Galderma Laboratories)] and clindamycin [tretinoin 0.025%/clindamycin phosphate 1.2% (Veltin, Aqua Pharmaceuticals; Ziana®, Valeant Pharmaceuticals)]."

The article does address the concern of "retinoid irritation" and offers "Strategies to minimize tolerability issues" in Table 1 but does not mention anything about long term risks of 'accutane induced rosacea' which many in RF and other anecdotal reports have confirmed happens to some. 

Dermatol Ther (Heidelb). 2017 Sep; 7(3): 293–304.
Published online 2017 Jun 5. doi:  10.1007/s13555-017-0185-2
PMCID: PMC5574737
Why Topical Retinoids Are Mainstay of Therapy for Acne
James Leyden, Linda Stein-Gold, and Jonathan Weiss