Trade name:
Retin-A

International name:
A Tretinoin (Tretinoin)

Group affiliation:
Regeneration stimulator

Description of the active substance (INN):
A Tretinoin

Dosage form:
cream for external use solution for external use

Pharmacological actions:
Natural metabolite of retinol, violates the expression of the gene that causes changes in the synthesis of proteins. Passes through the cell membrane and forms complexes with specific cytoplasmic receptors, which penetrate into the cell nucleus, bind to DNA. Depending on the condition of the tissue induced by (start the process of transcription and increases the number and RNA) or inhibited the synthesis of protein. A tretinoin inhibits gene transcription factor (AP I), that helps to reduce or eliminate the synthesis of metalloproteinases and elimination of negative impact of sunlight on the skin (including hyperpigmentation). A tretinoin decreases the amount of melanin in the epidermis, however, information about the change of the number and size of melanocytes are not available. The drug does not delay the sun's rays and is not used as a protective means from the sun. The induction of transcription leads to an increase in the number of epithelial cells, being in the state of mitosis, which contributes to the strengthening of the processes of proliferation in the papillary layer of the skin and the updating of the epithelium; reduces the adhesion of cells involved in the formation of the vulgar acne, and prevents the formation of keratin plugs, increases the synthesis glycosaminoglycan-like substances in rogovom layer of the epithelium. When processing an open acne helps to equalize the surface of the skin without signs of inflammation. When processing a closed acne facilitates their transition into the open acne or pimples, which are then heal without scarring after the removal of keratin cork. Prevents the formation of new acne. There is information that a tretinoin suppresses the synthesis of keratin of the skin, promotes hair growth (slightly) and has weak anti-tumor effect.

Indications:
Cream at the oil-water based gel for external application and solution for external use: acne vulgaris (including with the formation of comedones, papules, pustules, drain acne); follikuliarny keratosis, flat warts. Cream on water-oil-based: hyperpigmentation, roughness and wrinkling the surface of the skin, caused by exposure to sunlight (as a supporting therapy).

Contraindications:
Hypersensitivity, pregnancy, lactation, children's age to 12 years (with all of indications), up to 18 years of age (for the treatment of adverse effects of sunlight), age over 50 years (for the treatment of adverse effects of sunlight). C caution. Seborrheic dermatitis, eczema, sunburn, liver failure, pancreatitis, CHRONIC renal failure, chronic intoxication (including alcoholic intoxication), diabetes mellitus.

Side effects:
Local reactions: allergic reactions (moderate to marked) - tingling, redness, burning, swelling at the place of preparation, photosensitization; hypopigmentation of the skin, desquamation and dryness of the skin, blistering or crust; rarely - hyperpigmentation of the skin.

Way of administration and dosage:
Naruzhno applied on the affected area is very thin layer (gel and cream are finger, lotion, and solution - cotton swab) 1 times a day in the evening before bedtime, left on the skin for 6 h, after which it should be washed with running water; if necessary, the multiplicity of application increases up to two times a day. For people with light and dry skin exposure time of the preparation to the beginning of treatment is 30 minutes, then it can be gradually increased. In the course of treatment is allowed gently removed completely softened comedones and pustules. Duration of treatment depends on the type of pathology: in the treatment of vulgar acne therapeutic effect occurs in 2-3 weeks, in most cases - in 6-7 weeks; the best clinical effect is achieved after 3 months of therapy; in the treatment of adverse events from exposure to sunlight through 4-24 weeks. In the preventive purposes - 1 times per week, after a warm bath. Treatment of flat warts should start with the weak concentrations of tretinoin, in the absence of clinical effect increases as the concentration of the drug, and the frequency of its application (in case of absence of phenomena irritation of the skin).

Special instructions:
When an external application should avoid contact with eyes, mouth, mucous membranes (in case of contact wash off immediately with water). In the period of treatment is recommended to avoid exposure to the sun. Patients with sunburn, you can begin treatment after the weakening of the sun. After 1 week of therapy is likely to worsen the appearance of acne, which is connected with the action of the drug on deeply located acne, which were not visible before the start of treatment. You cannot assign simultaneously with the drugs causing desquamation epithelium, as well as with cosmetic and hygienic means that cause dryness and irritation of the skin. Sometimes for the treatment of vulgar acne recommend that the simultaneous appointment of oral isotretinoin and local forms of tretinoin, in the case of adverse effects or reduce the dose of one of retinoids, or the override to the disappearance of the undesirable phenomena. In the treatment of follicular keratosis irritation symptoms can be reduced with the help of simultaneous appointment of local STATE. It should not be used for the treatment of vulgar acne cream on water-oil based. It should be borne in mind that a tretinoin as monotherapy used for the treatment of vulgar acne I and II tbsp. of gravity. In more severe cases, to enhance the therapeutic effect it is recommended that a combination of tretinoin with antibiotics (local and systemic) or benzoyl peroxide. The effectiveness and safety in the treatment of photochemical skin and skin tumors are not installed. A tretinoin should not be used in deep-lined, yellowing of the skin, telangiectasia, "sluggish" skin, melanocytic atypia, elastosis skin.

Interaction:
The simultaneous use of tretinoin with local antibiotics (clindamycin, erythromycin), benzoyl peroxide, resorcinol, salicylic acid, astringent means, after-shave lotions, with agents containing pillingovye substances, sulfur, ethanol, cosmetics, soaps and means for care of hair, causing dryness of the skin, substances containing lemon or have an abrasive effect, may cause the strengthening of irritation and dryness of the skin (requires either a lower dose of tretinoin, or temporary cessation of treatment to the disappearance of adverse effects). Increases the speed and systemic absorption of minoxidil (local forms), which enhances hair growth and increases the risk of skin irritation (simultaneous use is not recommended). Concurrent administration with drugs that increase photosensitivity (including fluoroquinolones, phenothiazines, sulfonamides, tiazidnami dioretikami) increases the risk of photosensitivity (especially in the first months of the treatment), which requires either a lower dose of tretinoin, or temporary cessation of its application to the disappearance of adverse effects. During simultaneous usage with other retinoids (acitretin, etretinate, isotretinoin, oral tretinoin) strengthens the dryness and irritation of the skin.

Description of the preparation Retin-And is not intended for treatment without the participation of a doctor.