Topical retinoids have been around since 1971. They’re a group of vitamin A-based medications. A specific drug, called tretinoin, was approved by the FDA as a topical acne treatment. Soon after, dermatologists realized that it helped to reverse skin aging, too. Retinoids speed up the turnover of the cells on the surface of your skin. They also increase collagen levels. The combination of both improves acne, enhances skin tone, and reduces fine lines and wrinkles.
Retinoids shouldn’t be confused with retinol, which is used in over-the-counter skin care products to improve uneven skin tone, pigmentation, and texture. While retinol is a type of retinoid, it’s not as strong as what you’ll find in prescription topical skin products.
How Can Retinoids Help Treat Psoriasis?
The retinoid that’s used to treat psoriasis is called tazarotene (Tazorac). It’s available as a cream or gel. It works a little differently than other topical retinoids. The drugs used to treat acne and skin aging speed up cell division so newer cells can replace older, damaged cells. But tazarotene slows down the growth of rapidly growing skin cells. This means psoriasis can’t build up on your skin to form patches. It also reduces scaling.
Tazarotene also decreases inflammation in your body. It reduces the formation of two chemicals that can cause inflammation: cytokines and interleukins. As a result, over time you’ll notice an improvement in your psoriasis symptoms. You can also use it to treat nail psoriasis. It may reduce nail thickness and crumbling and may also help to restore normal nail growth.
What Should I Expect When I Take Tazarotene to Treat My Psoriasis?
You’ll use tazarotene once a day, usually in the evening. You’ll apply a thin layer of medicine to your psoriasis and rub it in completely. You should use the exact amount prescribed -- not more or less -- to reduce risk of side effects and ensure the drug works.
The psoriasis plaques may become very red in the first few weeks of use. This is very normal and will go away on its own. It shouldn’t hurt. The most common side effects of tazarotene are:
- Skin irritation
- Dry skin
- Increased susceptibility to sunburn
If you notice any of the above, you can apply tazarotene for 20 minutes and then wash it off to reduce the risk of skin irritation. Another option is to apply petroleum jelly first to the skin around your psoriasis before you apply the tazarotene. You should also always use sunscreen when outdoors and wear sun-protective clothing. Call your doctor if you notice severe burning, itching, or stinging.
If you're pregnant, don't use tazarotene since it may cause birth defects.
How Effective Is Tazarotene to Treat Psoriasis?
Tazarotene is safe and works well to treat psoriasis. Most people notice about a 50% reduction in their psoriasis. People who see their psoriasis clear after they use tazarotene often go into remission for as long as 3 months. Research shows that a higher dose of about 0.1 % is more effective than .05% cream, but it may lead to more side effects. Your body also absorbs very little tazarotene, which means that it’s unlikely you’ll develop any health problems from it.
If you do develop side effects, your doctor may also prescribe a prescription steroid to help lessen skin irritation. It also may be slightly more effective than if you use tazarotene alone. One prescription topical that contains both is called Duobrii. Since it doesn’t have a generic version, it can be very expensive -- up to $800 for a 100-gram bottle.
Your dermatologist may also recommend that you use a light treatment with ultraviolet light (UVB) to get better results from tazarotene. UVB is present in sunlight and can treat psoriasis since it slows the growth of affected skin cells. You can do this treatment at home or in your doctor’s office. Your doctor may prescribe less UVB exposure than they normally would since you’re already on tazarotene.
If you don’t get relief for your symptoms with tazarotene, talk to your doctor. There are other topical medications like calcipotriene and betamethasone dipropionate (Taclonex), roflumilast (Zoryve), or tapinarof (Vtama) that may be a better fit for you.
Show Sources
Photo Credit: Taro Pharmaceutical Industries
SOURCES:
American Osteopathic College of Dermatology: “Retinoids, Topical.”
Psoriasis and Psoriatic Arthritis Alliance (PAPAA): “Retinoids.”
American Academy of Dermatology: “Retinoid or Retinol?” “Psoriasis Treatment: A Retinoid You Apply to the Skin.”
UpToDate: “Patient education: Psoriasis (Beyond the Basics),” “Treatment of psoriasis in adults.”
National Psoriasis Foundation: “Non-Steroidal,” “Phototherapy.”
JAMA Dermatology: “The Safety and Efficacy of Tazarotene Gel, a Topical Acetylenic Retinoid, in the Treatment of Psoriasis.”
