Martin Kassir1, Priyanka Karagaiah2, Sidharth Sonthalia3, Andreas Katsambas4, Hassan Galadari5, Mrinal Gupta6, Torello Lotti7, Uwe Wollina8, Ayman Abdelmaksoud9, Stephan Grabbe10, Mohamad Goldust11,12,13. 1. Worldwide laser institute, Dallas, TX, USA. 2. Department of Dermatology, Bangalore Medical College and Research Institute, Bangalore, India. 3. Skinnocence: The Skin Clinic, Department of Dermatology & STD, Kalyani-Escorts Hospital, Gurgaon, India. 4. University of Athens, Athens, Greece. 5. College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates. 6. Treatwell Skin Centre, Jammu, India. 7. University of Studies Guglielmo Marconi, Rome, Italy. 8. Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University of Dresden, Dresden, Germany. 9. Mansoura Dermatology, Venerology and Leprology Hospital, Mansoura, Egypt. 10. Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany. 11. Department of Dermatology, University of Rome G. Marconi, Rome, Italy. 12. Department of Dermatology, University Medical Center Mainz, Mainz, Germany. 13. Department of Dermatology, University Hospital Basel, Basel, Switzerland.
Abstract
BACKGROUND: Acne vulgaris is a chronic disfiguring inflammatory disease of adolescents and adults affecting up to 90% of the population around the world. The sequence of etiopathogenesis in acne is not completely understood but involves abnormalities in sebum production, follicular plugging, proliferation of propionibacterium acnes, and chronic inflammation. AIMS: This review aims to summarize the features of the topical selective RAR agonists in treating acne vulgaris with a special emphasis on the 4th generation topical retinoid trifarotene. METHODS: Studies were identified by searching electronic databases (MEDLINE and PubMed) till August 2019 and reference lists of respective articles. Only articles published in English language were included. RESULTS: Topical retinoids have been first line of treatment for more than 30 years now in treating mild to moderate acne vulgaris. Third generation retinoids like adapalene and tazarotene are selective RAR and γ agonists, having an additional anti-inflammatory action along with their comedolytic effects and work well in combinations with topical antibiotics, due to the stability of chemical composition. CONCLUSION: Trifarotene is a new 4th generation retinoid with selective action on RAR-γ receptor alone, which is specific for skin, and it is safe for long-term maintenance therapy with good efficacy and tolerability.
BACKGROUND:Acne vulgaris is a chronic disfiguring inflammatory disease of adolescents and adults affecting up to 90% of the population around the world. The sequence of etiopathogenesis in acne is not completely understood but involves abnormalities in sebum production, follicular plugging, proliferation of propionibacterium acnes, and chronic inflammation. AIMS: This review aims to summarize the features of the topical selective RAR agonists in treating acne vulgaris with a special emphasis on the 4th generation topical retinoidtrifarotene. METHODS: Studies were identified by searching electronic databases (MEDLINE and PubMed) till August 2019 and reference lists of respective articles. Only articles published in English language were included. RESULTS: Topical retinoids have been first line of treatment for more than 30 years now in treating mild to moderate acne vulgaris. Third generation retinoids like adapalene and tazarotene are selective RAR and γ agonists, having an additional anti-inflammatory action along with their comedolytic effects and work well in combinations with topical antibiotics, due to the stability of chemical composition. CONCLUSION:Trifarotene is a new 4th generation retinoid with selective action on RAR-γ receptor alone, which is specific for skin, and it is safe for long-term maintenance therapy with good efficacy and tolerability.