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Teratogenicity

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Related Experiment Video

Updated: Dec 15, 2025

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

Published on: July 11, 2013

Teratogen update: Topical use and third-generation retinoids.

Amy Lavin Williams¹, Nelson D Pace^2,3, John M DeSesso^1,4

¹Exponent, Inc., Alexandria, Virginia, USA.

Birth Defects Research

|July 10, 2020

Summary

Topical retinoids, including newer generations, show low teratogenic risk in humans. While use in pregnancy is not recommended, accidental exposure is unlikely to cause adverse pregnancy outcomes.

Keywords:

adapalene alitretinoin bexarotene birth defects dermal malformations retinoids tazarotene teratogenesis topical tretinoin

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Area of Science:

Dermatology
Teratology
Pharmacology

Background:

First-generation retinoids, similar to vitamin A, carried teratogenic risks, leading to black-box warnings for pregnancy.
Early oral retinoids have been reformulated for topical use, reducing systemic exposure and associated risks.
Third-generation retinoids (adapalene, tazarotene, bexarotene) feature structural modifications limiting off-target effects.

Purpose of the Study:

To evaluate the teratogenic potential of pharmaceutical retinoids, particularly newer topical formulations, during pregnancy.
To assess the safety profile of retinoids in pregnant individuals based on available animal and human data.

Main Methods:

Review of existing literature on retinoid teratogenicity.
Comparison of structural differences between first-, second-, and third-generation retinoids.
Analysis of animal study data and limited human epidemiological data.

Main Results:

Third-generation and reformulated topical retinoids demonstrate reduced teratogenic potential in animal models compared to older oral retinoids.
Available human epidemiological data suggest minimal to no teratogenic risk associated with real-world topical retinoid use.
Despite low risk, comprehensive human data remain limited.

Conclusions:

Topical retinoid use during pregnancy is generally not recommended due to limited human data.
In cases of inadvertent exposure, current evidence suggests a low likelihood of adverse pregnancy outcomes.
Further epidemiological studies are warranted to fully establish the safety of topical retinoids in pregnancy.