What Are Oral Retinoids?
Oral retinoids are recommended for psoriasis, they are synthetic drugs derived from Vitamin A. There are two kinds of retinoids, isotretinion and acitretin. Isotretinoin contains an ingredient related to Vitamin A, and is used primarily to treat acne. I’ve found a link with isotretinoin and ulcerative colitis, amongst other side effects. These drugs can tend to have rather strong side-effects, and one day may be overtaken by biologic therapies for psoriasis, which are currently far too expensive to even contemplate for the average psoriasis patient.
Acitretin helps to slow the rapid growth of skin cells, thereby reducing the redness, thickness and scaling found in the skin of those who have psoriasis.
Acitretin is not unlike isotretinoin, but is prescribed by dermatologists primarily for psoriasis; it results in slow improvements over a period of several months and is targeted treatment for moderate to severe psoriasis that has failed to respond to topical treatments and phototherapy. Some patients may notice a temporary worsening of their condition before any improvements are noticed. Sometimes this drug will be used in combination with topical corticosteroids or calcipotriol.
This drug is well known to cause birth defects if given to pregnant women, so don’t be surprised if you are a female and your doctor requests a pregnancy test first. Pregnancy must be strictly avoided whilst on acitretin and for at least 2 years afterwards because it may cause birth deformities. Your doctor will also want complete blood tests performed, including kidney and liver function tests as well as a fasting blood lipid test to determine your cholesterol and triglyceride levels before prescribing this drug.
There are many precautions around taking this drug this drug, especially if you are a female, and the risk of side effects is significantly increased if you drink any alcohol, or take any minocycline, doxycycline, or tetracycline (antibiotics), methotrexate, cyclosporine, of dietary supplements like St. John’s Wort or real Vitamin A. Check with your doctor, because this not the complete list. The drug guide I was studying also mentioned not to have any cosmetic procedures performed on you skin while taking acitretin, because retinoids can increase your chance of scarring or skin inflammation.
Sun safety tips if you do take acitretin.
- Wear protective clothing; especially long sleeves and a wide-brimmed hat.
- Use a broad-spectrum sunscreen with a high SPF rating.
- Look for the shade; don’t spend too much time in the sun!
- Avoid peak exposure, the sun is strongest between 10 A.M. and 3.00 P.M.
Reasons you would not want to take acitretin
- You are pregnant or planning a pregnancy
- Nursing women
- Not wanting to use birth control
- Experiencing any liver or kidney health issues
- Experiencing moderate or high cholesterol/triglyceride elevation
- Experiencing leucopenia (low white blood cells)
Side effects of acitretin include chapped or dry lips, peeling palms and soles, thinning hair or hair loss, muscle pains, nose bleeds, dry mouth, dry or irritated eyes, pain behind the eyes or blurred vision, headaches, vomiting. Stop the drug at once and contact your doctor if you experience any of the these side effects.