The cutaneous safety of topical tretinoin

Topical tretinoin is a valuable therapeutic agent whose chief drawback has been local primary irritation. What were thought to be special difficulties with photosensitivity reactions and pigmentary changes in dark skin, really turn out to be other manifestations of the irritancy. Advances in the development of newer dosage forms and treatment regimens, together with expanded knowledge of the many factors which contribute to the problem, mean that there should be very few patients who cannot be treated with tretinoin. Only the rare patient with true hypersensitivity to the drug need be denied. Appropriate therapy still requires a modicum of personal attention to the individual patient's needs-but that is what the practice of medicine is all about.