Do topical retinoids cause acne to "flare"?
BACKGROUND
Guidelines support this use of topical retinoids as a fundamental part of acne treatment regimens. However, existing dogma holds that topical retinoids may initially worsen acne.


OBJECTIVE
To review the available data from clinical trials for evidence of initial worsening of acne with topical retinoids.


METHODS
A PubMed and Google Internet search was performed for sources indicating or refuting worsening of acne with topical retinoids.


RESULTS
No primary data from clinical trials were identified to support the dogma of acne worsening secondary to topical retinoids. Available data point to topical retinoids improving acne, even during the first couple weeks of treatment.


CONCLUSIONS
It is unlikely that acne worsens or "flares" due to the initiation of topical retinoids. Some acne patients may have worsening of acne during the first week or two as part of the natural disease process.
Yentzer
Brad A
BA
Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine,Winston-Salem, NC 27157-1071, USA.
McClain
Richard W
RW
Feldman
Steven R
SR
D000152:Acne Vulgaris / Q000188:drug therapy* / Q000473:pathology; D000279:Administration, Cutaneous; D002986:Clinical Trials as Topic; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D012176:Retinoids / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D012720:Severity of Illness Index
D003879:Dermatologic Agents; D012176:Retinoids