Table of ContentsView AllTable of ContentsHow They WorkTazorac (Tazarotene)Soriatane (Acitretin)
Table of ContentsView All
View All
Table of Contents
How They Work
Tazorac (Tazarotene)
Soriatane (Acitretin)
Retinoids are forms of Vitamin A delivered in topical and oral formulations that can slow the growth of skin cells in people withpsoriasis.Since their introduction in 1971, retinoids have been used to treat a variety of skin concerns including fine wrinkles, flat warts, acne, and certain types of skin cancer.
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In total, there are six topical and five oral retinoids approved for use in the United States. Of these, two are indicated for the treatment of psoriasis:
Both are contraindicated for use in pregnancy.
How Plaque Psoriasis Is Treated
Uses
Tazorac is approved to treat mild to moderate plaque psoriasis covering less than 20% of the body in adults and children under the age of 12. Younger children should only use the product under the direction of a qualifieddermatologist.
Topical corticosteroids, along with emollient moisturizers, are usually more effective at bringingsymptomsunder control than Tazorac.As such, Tazorac is generally used iftopical corticosteroidsfail to provide relief or cause seriousside effects. It is rarely used on its own and may be combined with a topical steroid or vitamin D derivative to reap the benefits of both.
Tazorac is also effective as a maintenance therapy once the condition is brought under control as it has fewer long-term side effects.It is also known to increase light sensitivity and may enhance the benefits ofphototherapy.
Tazorac can even be used to support the treatment of severe psoriasis when used in combination with stronger oral or injected drugs.
Contraindications
Tazorac carries aboxed warningadvising women to never use the drug during pregnancy, as studies have shown it can cause fetal harm.It should, therefore, only be considered when no other options are available.
Tazorac should not be used in people with a known allergy to tazarotene or any of the other ingredients in the product.
Dosage
Tazorac is available in cream, gel, and foam formulations in 0.05% and 0.1% strengths. Comparatively speaking, the 0.1% formulation is more effective but is also more likely to cause side effects. Because of this, your dermatologist will likely prescribe a 0.05% formulation and switch you to the stronger 0.1% formulation if needed.
Unlike most corticosteroid creams, the 0.1% formulation is safe to use on the face. The foam version is especially useful for treatingscalp psoriasisas it can better penetrate thick hair.
Application
Tazorac is used once daily and applied to the affected skin only. To prevent dryness, rub some light moisturizing cream onto the skin before applying a thin layer of Tazorac cream. You can do the same with the scalp, but avoid heavier scalp serums or oils that can block absorption.
Tazorac should never be used internally, including the mouth, vagina, or anus. It should also not be applied to thegenitalsunless your dermatologist tells you to. If you get some in your eyes, rinse thoroughly with water.
To avoid irritating the surrounding skin, dab a barrier of petroleum jelly around the border of the plaque before applying Tazorac.
Side Effects
The most common side effects of Tazorac use (affecting 10% to 30% of users) are:
Many of these side effects will resolve as your body adapts to the medication; however, you may need to lower the dose or “pulse” treatment with on and off days until you are better able to tolerate it. Speak with your healthcare provider before adjusting your dosing.
In addition to the above, some people may experience a short-term worsening of psoriasis symptoms themselves.
Tazorac can also make your skin extremely sensitive to the sun. Because of this, you need to use sunscreen and wear protective clothing whenever outdoors. Unprotected skin is more likely to burn, which may, in turn, trigger a worsening of symptoms.
Call your healthcare provider if the side effects persist or worsen, or if you experience blistering, peeling, rash, severe redness, swelling, warmth, oozing, or fever.
Interactions
If you takemedications that increase photosensitivity, you will need to take extra precautions when outdoors or switch to another product.
Examples of drugs that can interact with Tazorac include:
Advise your healthcare provider about any drugs you are taking before starting treatment, including over-the-counter medications, dietary supplements, herbal remedies, and recreational drugs. Never stop Tazorac without your healthcare provider’s approval.
Tazarotene vs. Tretinoin: Comparing These Two Retinoids
Soriatane is only used in adults with severe psoriasis who have not responded to first- and second-line drugs likehydrocortisone cream, methotrexate, or cyclosporine.Severe psoriasis is generally defined as having psoriatic plaques on more than 30% of the body or on large portions of the face, palms, or soles.
Soriatane is often used in combination with phototherapy or newer-generationbiologic drugslikeHumira (adalimumab)and Enbrel (etanercept).
Likewise, it is not known whether Soriatane can pass through breastmilk, so discuss use of the drug if you breastfeed or plan to do so.
Soriatane should not be used in people with a known allergy to acitretin or any other ingredient in the drug. Other contraindications include:
Soriatane is available as a gel cap in a 10-milligram (mg), 17.5-mg, or 25-mg strength. It is generally prescribed in a once-daily, 25-mg to 50-mg dose and taken with food for optimal absorption.
While effective, it can take up to three months before you feel the benefits of Soriatane treatment. During this time, you may experience a temporary worsening of symptoms. This is normal and is not an indication that the treatment is failing.
The side effects of Soriatane use are significant and sometimes severe. In fact, according to the FDA, 98% of users will experience side effects; no less than one in four users will discontinue treatment due to intolerability.
The most common side effects of Soriatane (occurring in at least 10% of users) include:
Soriatane can affect other organ systems as well, including the heart, brain, liver, and circulatory system. This can result in less common but potentially more serious side effects.
Call your healthcare provider if you experience confusion, suicidal thoughts, vomiting, difficulty speaking or moving, yellowing of the eyes or skin, chest pains, irregular heartbeats, or any other symptom that doesn’t seem right.
Soriatane can interact with other medications, often increasing or decreasing the blood concentration of one or both drugs. These include:
Pregnancy Prevention
Given the risks these drugs pose to fetuses, it is recommended that women have a negative pregnancy test two weeks prior to starting treatment with Soriatane.Some healthcare providers will advise their female patients to start treatment during their period when they are definitely not pregnant.
Woman of child-bearing age who take Soriatane must usecontraceptionconsistently and take pregnancy tests every month. Women on Soriatane need to continue this for three yearsafter treatment is stoppeddue to the persistence of the drug in the body.
If a positive pregnancy test result is returned, you will need to stop treatment immediately and call your healthcare provider. If you are unable to adhere to contraception, you may need to choose a form of treatment other than Soriatane.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Khalil S, Bardawil T, Stephan C, et al.Retinoids: a journey from the molecular structures and mechanisms of action to clinical uses in dermatology and adverse effects.J Dermatolog Treat. 2017;28(8):684-696. doi:10.1080/09546634.2017.1309349Heath MS, Sahni DR, Curry ZA, Feldman SR.Pharmacokinetics of tazarotene and acitretin in psoriasis.Expert Opin Drug Metab Toxicol. 2018;14(9):919-927. doi:10.1080/17425255.2018.1515198Kim WB, Jerome D, Yeung J.Diagnosis and management of psoriasis.Can Fam Physician. 2017;63(4):278-85.Torsekar R, Gautam MM.Topical therapies in psoriasis.Indian Dermatol Online J. 2017;8(4):235-245. doi:10.4103/2229-5178.209622PDR.Tazarotene drug summary.Sarkar, R., Chugh, S. Garg, V.Acitretin in dermatology.Indian J Dermatol Venereol Leprol.2013;79(6):759. doi:10.4103/0378-6323.120721PDR.Soriatane.U.S. Food and Drug Administration.Soriatane (acitretin) capsules.Additional ReadingMehta B, Amladi S.Evaluation of topical 0/1% tazarotene cream in the treatment of palmoplantar psoriasis: An observer-blinded randomized controlled study.Indian J Dermatol.2011;56(1):40–43. doi:10.4103/0019-5154.77550U.S. Food and Drug Administration.Highlights of prescribing information: Tazorac (tazarotene) gel, 0.05% and 0.1%, for topical use.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Khalil S, Bardawil T, Stephan C, et al.Retinoids: a journey from the molecular structures and mechanisms of action to clinical uses in dermatology and adverse effects.J Dermatolog Treat. 2017;28(8):684-696. doi:10.1080/09546634.2017.1309349Heath MS, Sahni DR, Curry ZA, Feldman SR.Pharmacokinetics of tazarotene and acitretin in psoriasis.Expert Opin Drug Metab Toxicol. 2018;14(9):919-927. doi:10.1080/17425255.2018.1515198Kim WB, Jerome D, Yeung J.Diagnosis and management of psoriasis.Can Fam Physician. 2017;63(4):278-85.Torsekar R, Gautam MM.Topical therapies in psoriasis.Indian Dermatol Online J. 2017;8(4):235-245. doi:10.4103/2229-5178.209622PDR.Tazarotene drug summary.Sarkar, R., Chugh, S. Garg, V.Acitretin in dermatology.Indian J Dermatol Venereol Leprol.2013;79(6):759. doi:10.4103/0378-6323.120721PDR.Soriatane.U.S. Food and Drug Administration.Soriatane (acitretin) capsules.Additional ReadingMehta B, Amladi S.Evaluation of topical 0/1% tazarotene cream in the treatment of palmoplantar psoriasis: An observer-blinded randomized controlled study.Indian J Dermatol.2011;56(1):40–43. doi:10.4103/0019-5154.77550U.S. Food and Drug Administration.Highlights of prescribing information: Tazorac (tazarotene) gel, 0.05% and 0.1%, for topical use.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Khalil S, Bardawil T, Stephan C, et al.Retinoids: a journey from the molecular structures and mechanisms of action to clinical uses in dermatology and adverse effects.J Dermatolog Treat. 2017;28(8):684-696. doi:10.1080/09546634.2017.1309349Heath MS, Sahni DR, Curry ZA, Feldman SR.Pharmacokinetics of tazarotene and acitretin in psoriasis.Expert Opin Drug Metab Toxicol. 2018;14(9):919-927. doi:10.1080/17425255.2018.1515198Kim WB, Jerome D, Yeung J.Diagnosis and management of psoriasis.Can Fam Physician. 2017;63(4):278-85.Torsekar R, Gautam MM.Topical therapies in psoriasis.Indian Dermatol Online J. 2017;8(4):235-245. doi:10.4103/2229-5178.209622PDR.Tazarotene drug summary.Sarkar, R., Chugh, S. Garg, V.Acitretin in dermatology.Indian J Dermatol Venereol Leprol.2013;79(6):759. doi:10.4103/0378-6323.120721PDR.Soriatane.U.S. Food and Drug Administration.Soriatane (acitretin) capsules.
Khalil S, Bardawil T, Stephan C, et al.Retinoids: a journey from the molecular structures and mechanisms of action to clinical uses in dermatology and adverse effects.J Dermatolog Treat. 2017;28(8):684-696. doi:10.1080/09546634.2017.1309349
Heath MS, Sahni DR, Curry ZA, Feldman SR.Pharmacokinetics of tazarotene and acitretin in psoriasis.Expert Opin Drug Metab Toxicol. 2018;14(9):919-927. doi:10.1080/17425255.2018.1515198
Kim WB, Jerome D, Yeung J.Diagnosis and management of psoriasis.Can Fam Physician. 2017;63(4):278-85.
Torsekar R, Gautam MM.Topical therapies in psoriasis.Indian Dermatol Online J. 2017;8(4):235-245. doi:10.4103/2229-5178.209622
PDR.Tazarotene drug summary.
Sarkar, R., Chugh, S. Garg, V.Acitretin in dermatology.Indian J Dermatol Venereol Leprol.2013;79(6):759. doi:10.4103/0378-6323.120721
PDR.Soriatane.
U.S. Food and Drug Administration.Soriatane (acitretin) capsules.
Mehta B, Amladi S.Evaluation of topical 0/1% tazarotene cream in the treatment of palmoplantar psoriasis: An observer-blinded randomized controlled study.Indian J Dermatol.2011;56(1):40–43. doi:10.4103/0019-5154.77550U.S. Food and Drug Administration.Highlights of prescribing information: Tazorac (tazarotene) gel, 0.05% and 0.1%, for topical use.
Mehta B, Amladi S.Evaluation of topical 0/1% tazarotene cream in the treatment of palmoplantar psoriasis: An observer-blinded randomized controlled study.Indian J Dermatol.2011;56(1):40–43. doi:10.4103/0019-5154.77550
U.S. Food and Drug Administration.Highlights of prescribing information: Tazorac (tazarotene) gel, 0.05% and 0.1%, for topical use.
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