Topical Isotretinoin (Isotrex) is a retinoid medication that is used as a topical treatment for certain types of skin disorders, including acne. Topical retinoids are popular acne treatments that can help improve symptoms for many individuals. Topical Isotretinoin is an older-generation topical retinoid that has largely been replaced by newer topical retinoids (eg. Adapalene, Tazarotene). Topical Isotretinoin contains the same active ingredient as the more well-known oral form of this medication – Accutane.
Retinoids are derivatives of Vitamin A. Retinoids can help improve acne symptoms in several ways. Retinoids decrease the activity of the sebaceous glands, which decreases the production of sebum. The decrease in sebum in eliminates decreases the amount of nutrients that are available for acne-causing bacteria that live deep within hair follicles. Retinoids can also affect the growth and differentiation of skin cells, which can help reduce the formation of clogged pores (comedomes). Retinoids also have anti-inflammatory affects which may help improve acne symptoms.
Isotretinoin works by entering target cells and binding to to specific receptors called Retinoic Acid Receptors that are in the nucleus of cells. Once the retinoid binds to these receptors it changes how the genes of that cell are expressed. These changes in gene expression are what give retinoids their anti-acne properties.
Topical Isotretinoin is becoming less popular for the treatment of acne. Topical Isotretinoin tends to be less effective and have more significant side effects than alternative topical retinoids (eg. Adapalene, Tazarotene, Tretinoin).
Topical Isotretinoin is frequently used in combination with complementary anti-acne medications, such as topical or oral antibiotics. These combinations are often more effective at improving acne symptoms and improve the overall effectiveness of treatment. Topical Isotretinoin and other topical retinoids tend to be more effective for the treatment of mild acne (Acne Types: 1-2) and less effective for moderate and severe forms of the disease (Acne Types: 3-4). Some available medications combine Isotretinoin with another antibacterial compound, such as Erythromycin (eg. Isotrexin).
The most common side effect of treatment of Topical Isotretinoin use is dryness of the skin. Isotretinoin treatment decreases the production of sebum, and sebum is essential for moisturizing and protecting the skin. Isotretinoin tends to have more significant side effects than newer topical retinoids, such as Adapalene and Tazarotene.
The most serious potential side effect of Isotretinoin is a risk of birth defects. All retinoids are teratogens (compounds that can cause birth defects). However, several studies have indicated that there is minimal risk to the fetus from the topical use of retinoids, including Isotretinoin. Nonetheless, the use of any type of retinoid is generally avoided in all women who are pregnant or may become pregnant during treatment.