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Retinoids are the quintessential first-line treatment for acne vulgaris


Retinoids reduce keratinocyte proliferation by binding to specific receptors in the cell's nucleus. Retinoids also reduce skin bacteria by reducing their supply of nutrients.

Retinoid Generations

Currently, there are four FDA-approved generations of topical retinoids:

First Generation

Tretinoin, also referred to as all-trans retinoic acid (ATRA)

Second Generation



Third Generation

Adapalene and tazarotene

Fourth Generation

Trifarotene - fourth-generation.

Side effects with Retinoids

The most common adverse effects of topical retinoid use are drying, stinging, and burning upon application.

Combining Retinoids

Retinoids have recently been combined with BPO as a combined treatment.

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