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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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What is Dovonex (Calcipotriene)?

Saturday, October 10th, 2009

Dovonex (a.k.a. calcipotriene or calcipotriol) is a topical psoriasis treatment used to control the excessive skin cell production (plaque psoriasis).  It a vitamin D derivative that is available by prescription only.   It is also known as calcipotriol, or calcipotriene.

The exact mechanism by which Dovonex controls skin cell production is not known, though it is thought to have a regulatory effect on T-cell activity.  T-cells are a part of the immune system that bring about excessive skin cell growth in response to psoriasis.

Typical dosage for Dovonex is twice daily to affected areas of the skin.

It was discovered that the corticosteroids helped to speed up the effects of Dovonex, so these two are sometimes prescribed simultaneously.  Mixing steroids with synthetic vitamin D brought about a new drug that was approved by the FDA in 2008 called “Taclonex.”

Dovonex has also been mixed with other topical treatments such as anthralin, Tazorac and coal tar to make it more effective.

Anyone on Dovonex should be careful about staying in the sun since it has been shown to increase the skin’s sensitivity to UV rays, in particular by speeding up the rate at which skin cancer develops.  Other side effects include excessive calcium absorption, irritation and a worsening of psoriasis symptoms.  Pregnant women are strongly advised against using this drug.  On rare occasions Dovonex has also been known to cause mood swings, a stretching / thinning of the skin, pair follicle pustules, dizziness and abdominal pain.

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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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