Do topical retinoids cause acne to "flare"?

Area of Science:

• Dermatology
• Pharmacology

Background:

• Topical retinoids are a cornerstone of acne vulgaris treatment according to established guidelines.
• A common misconception suggests that topical retinoids may initially exacerbate acne symptoms.

Purpose of the Study:

• To critically evaluate clinical trial data for evidence supporting the initial worsening of acne upon initiation of topical retinoid therapy.

Main Methods:

• A comprehensive literature search was conducted using PubMed and Google.
• The search focused on identifying studies that either supported or refuted the claim of initial acne worsening with topical retinoid use.

Main Results:

• No primary clinical trial data were found to substantiate the belief that topical retinoids cause initial acne worsening.
• Existing evidence suggests that topical retinoids effectively improve acne, even within the initial weeks of application.

Conclusions:

• The notion that acne flares upon starting topical retinoids is likely unfounded.
• Any observed worsening in the first few weeks of treatment may be attributable to the natural course of acne vulgaris.