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Are Retinoids an Effective Treatment for Psoriasis?

Friday, October 16th, 2009

Retinoids are vitamin A derivatives used to treat psoriasis, acne and other skin conditions.  There are thousands of variations on this molecular structure that might, in turn, be used to treat a large number of different ailments.

Some of the best known retinoids used for treating psoriasis include tazarotene (brand name Tazorac), acitretin (brand name Soriatane) and isotretinoin (brand name Accutane).  Acitretin was implemented in the U.S. market as a safer version of etretinate, which was removed from U.S. markets due to the drug’s harmful effects on pregnancies.  Retinoids can be administered topically as a gel or cream and they can be taken orally.

Retinoids have gained a lot of popularity because their regulatory effect on skin cell production and swelling, which are two of the main symptoms associated with psoriasis.  The method by which retinoids reduce psoriasis is not fully understood.

Future developments of retinoids may lead to DNA-specific behavior, by which the characteristics of cells that would pass psoriasis from one to another can be blocked entirely.

Side effects to taking retinoids include irritated skin, increased acne (at first), dryness / peeling, hair loss, depression, impotency in males, increased sensitivity to light and liver damage.  Be sure that your doctor knows about all other medications you are taking if you are considering any retinoid therapy as they can interact with other drugs with severe side-effects.  To reduce the toxic effect retinoids can have on the body, UV light therapy (UVA and UVB rays) has been used to amplify the effect of smaller doses.

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Tazorac (Tazarotene) – A Unique Topical Psoriasis Medication

Wednesday, October 7th, 2009

Tazorac is a topical retinoid, which means it is a vitamin A derivative.  Retinoids are what I would classify as one of the “harsher” types of drugs, since they affect immune system functionality and can thus result in some severe side effects.  Besides psoriasis, Tazorac is also commonly used to treat acne.  By my understanding, it is the topical equivalent of Accutane.

Chemists / pharmaceutical firms have developed a variety of different retinoids that have varying effects depending on the patient and their particular condition.  Tazorac’s active ingredient, tazarotene, is considered a “third generation” retinoid.

Administering retinoids via a topical solution may pose less health risks than taking them orally.  On the downside, people using Tazorac to treat psoriasis will inevitably see their symptoms return (sometimes months) after usage of this medication is stopped.  Several months of remission after stopping treatment is a long time compared to other topical psoriasis medications, but this still falls short of the goal, which is to be psoriasis free for life.

Tazorac comes in the form of a non-staining gel or a cream solution.  It was approved by the FDA in 1997 at which time it was hailed as a major breakthrough in topical skin treatment.

Tazorac has proven to be an effective psoriasis treatment as it regulates skin cell growth and keeps swelling down.  Some doctors even prescribe it alongside topical steroid treatments and have seen ever greater remissions.  It can be applied to any surface of the body including the scalp, though contact with more sensitive areas such as the eyelids is not recommended.

Tazorac is available only through a doctor’s prescription.  Tazarotene is also marketed under the brand names Avage and Zorac (also available by prescription only).

Side effects of using Tazorac include in dry and sometimes irritated skin.  Pregnant women should definitely not use Tazorac as this similar medications have been proven to cause birth defects.

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How Does Pregnancy Affect Psoriasis?

Tuesday, October 6th, 2009

Consistent with the unpredictability that characterizes psoriasis in general, pregnancy may or may not improve your psoriasis.

The main difference between being pregnant or not is hormone levels.  There are a variety of theories about how pregnancy hormone levels might improve psoriasis, but this subject matter still remains relatively unexplored.  You may be able to come to your own conclusions based on these approximated trends:

  • 50% of pregnant women with psoriasis see their symptoms improve
  • 25% get worse
  • 25% stay the same

Most pregnant women with psoriasis see their condition improve during pregnancy and then worsen afterward.  Also, with multiple pregnancies, the psoriasis symptoms in question tend to be the same for each pregnancy (if the psoriasis improved during the first trimester last time, that will most likely happen again, etc.).

As a general rule, psoriasis does not affect a woman’s (or a man’s) reproductive ability nor does it pose a threat to the child after it is conceived.  Of course, it would be a good idea to let your obstetrician just in case.

An aspect of being pregnant with psoriasis that should be handled with care is the medications that you are taking to treat your psoriasis.  Many psoriasis medications can be extremely detrimental to your baby’s health, especially retinoids (relatives of Accutane).  Even regular supplements can be harmful to your baby, so this would be at the top of your obstetrician question list.  Mothers with psoriasis who plan on breastfeeding should also take every possible precaution since these medications can pass on to the baby.

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