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Deeper Questions About Tretinoin And Acne In General (And Health Warning)

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I've been doing some reading on the internet about acne. I came across a website called ScienceOfAcne.com, which has a lot of information that other sites do not. It really goes deeper into the scientific side of things. This website seems to say that most forms of acne share at least one thing in common, and that is overactive sebacious glands or enlarged sebacious glands, or both.

This condition is called "sebaceous hyperplasia," and it is either solely caused by, or mostly caused by, excess of the androgen hormones in the body. Those of us who use retinoids with success have this condition. I am one such individual.

http://scienceofacne.com/in-depth-the-sebaceous-glands

One of the most effective treatments for overactive or hyperplastic sebaceous glands are retinoic acids.

Retinoic acid causes sebaceous glands to decrease in size and reduces their growth rate, resulting in dramatically decreased sebum production. In some cases, treatment with retinoic acid can decrease the production of sebum by up to 90%.


- I have insulin resistance and high DHEA-S as indicated on my fasting insulin test and DHEA-S test.

- Acne clears up almost completely when low carbing.

- Quit Retin-A 0.05% and experienced no changes.


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birth defects are well known and discussed for accutane. if you were prescribed accutane by a dermatologist he should have made it extremely clear.

however, topical isotretinoin derived creams do not effect foetuses, AS FAR AS I KNOW!!

i think the absorption rates through the skin are negligible in comparison to oral treatments.

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When my derm prescribed me Differin, she warned me that I can not get pregnant for the above reasons.

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Here's a nice summary about topical prescription retinoids and acne:

"The amount of drug absorbed from the skin when using this product is very low; however, there are 4 published case reports of birth defects in the literature associated with topical tretinoin use, which are consistent with retinoid embryopathy. The role of the topical retinoids in these cases remains controversial,1518 as 2 prospective studies that examined use during the first trimester of pregnancy with 96 and 106 women did not find an increased risk of major malformations or evidence of retinoid embryopathy.19,20 However, until data on larger cohorts are collected, women should not be encouraged to use topical retinoids during pregnancy."

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114665/

And another one here:

"n 1998 several cases of malformations similar to those induced by oral retinoids were reported in children exposed in utero to topical retinoids (adapalene and tretinoin). The results of two somewhat flawed epidemiological studies were reassuring. (2) New cases of birth defects were subsequently reported in children exposed in utero to topical tretinoin. (3) Epidemiological data are still scant and unconvincing: they neither confirm this risk nor rule it out completely. (4) It is best to avoid using topical retinoids altogether in early pregnancy. Women of child-bearing age must be fully informed of the risks and the importance of effective contraception. This also applies to patients with moderate forms of psoriasis, for which topical tazaroten is indicated."

http://www.ncbi.nlm.nih.gov/pubmed/15981398

There's quite a bit of doubt on the dermatologist's side that topical retinoids cause birth defects in fetuses because of the very tiny amounts of retinoic acid (0.05% to 0.1% or so) and the amount applied (pea-sized), plus it's limitation to the face and considering it's difficult for topicals in general to permeate the skin, not to mention tretinoin's half-life is at most 2 hours. There's some research about tretinoin and systemic absorption, concluding there are "negligible" amounts. Of course, since it's not totally ruled out that it doesn't cause fetal harm, some dermatologists and mothers would rather be "safe than sorry" and minimize any potential risk, no matter how small.

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I've been doing some reading on the internet about acne. I came across a website called ScienceOfAcne.com, which has a lot of information that other sites do not. It really goes deeper into the scientific side of things. This website seems to say that most forms of acne share at least one thing in common, and that is overactive sebacious glands or enlarged sebacious glands, or both.

This condition is called "sebaceous hyperplasia," and it is either solely caused by, or mostly caused by, excess of the androgen hormones in the body. Those of us who use retinoids with success have this condition. I am one such individual.

http://scienceofacne...ebaceous-glands

One of the most effective treatments for overactive or hyperplastic sebaceous glands are retinoic acids.

Retinoic acid causes sebaceous glands to decrease in size and reduces their growth rate, resulting in dramatically decreased sebum production. In some cases, treatment with retinoic acid can decrease the production of sebum by up to 90%.

That is astounding. It can reduce sebum production by up to 90% and yet I still have oily skin. Imagine how oily our faces would be if we stopped using retinoids. I can't even imagine. My face would nearly be dripping with oil...that is scary...

And if you think that is scary, wait till you read this part, which I have never heard about until now:

http://scienceofacne...ebaceous-glands

The most troubling side effect of retinoic acid is its effect on the developing fetus. Retinoic acid dramatically disrupts normal embryonic development and leads to severe birth defects. For this reason, retinoic acid treatments are tightly controlled in many places, particularly for women.

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Yeah I think the jury is out on whether topical retinoids cause birth defects. The manufacturer and doctors are going to rule on the side of protecting themselves and tell you not to use it. However there have been clinical reviews of small sample sizes that found no greater birth defects in groups who had used retinoids during pregnancy than those who didn't. And the amount that is absorbed is very, very low. I think people relate them to Accutane and freak out.

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