Safety and effectiveness in a geriatric population have not been established. Clinical studies of Acretin did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger patients.
Unfortunately Acretin is pretty irritating. Tina Fey didn’t say you’ll see wafting chunks of peeling skin for no reason.
Why is Acretin such a popular anti-aging skin care product?
Many scientific studies, and my own experience utilizing Acretin personally and in my practice, have shown these powerful results:
- Acretin has proven itself to reduce, reverse and prevent wrinkles. (The younger a person starts using it, meaning in their teens and twenties, the more benefits they receive. But, it’s never too late to start using it!)
- Acretin helps lighten and prevent age spots.
- Acretin builds collagen to thicken and increase the structural strength of treated skin.
- Acretin helps to decrease a person’s risk of developing skin cancer. (This should be reason enough!)
- Skin just looks better and younger when people use Acretin.
When used correctly, Acretin does amazing things for skin!
So then what is Retinol?
Now Acretin is the purest form, so after Acretin we have Retinol. Retinol is about 20 times weaker than Acretin, so it basically does the same thing but it’s not nearly as strong. This means it’s not going to create as much of a result and it’s not going to cause as much of that dry, flaky result that we experience from Acretin.
Acretin is somewhat effective against PIH (post inflammatory hyperpigmentation), though not terribly impressive in this department. It works by inhibiting tyrosinase (an enzyme that produces melanin), interfering with pigment transfer, and speeding up cell turnover rate. (15, 16)
One study assessed its efficacy in treating liver spots (a.k.a age spots), or the brown and black spots commonly seen on elderly folks. The study was 10 months long, involved 58 patients, 24 of which used Acretin cream 0.1% daily. At the end of it, 83% of the Acretin users saw a reduction in age spots. (17) Another similar study found improvement in 68% of patients after 10 months of daily Acretin cream 0.1%. (18)
In my opinion, 10 months and only slight or no improvement in nearly 20% to 30% of patients isn’t groundbreaking. Especially considering these participants were using the strongest prescription Acretin available.
Acretin’s ability to treat melasma has also been assessed. One study found a 32% improvement across all patients after 10 months of daily Acretin cream 0.1%. (19) Again, I don’t know about you, but 10 months for a 32% improvement — ain’t nobody got time for that.
Sorry if I sound overly critical here, :p but in my humble opinion Acretin is a bit overrated in its ability to reduce hyperpigmentation. And if used excessively, it can actually cause or make erythema like PIE worse! One study found “moderate side-effects of erythema” in 88% of patients treated with Acretin! (20) The researches ended up ruling that Acretin helps, but improvement is slow.
This is why it’s particularly important to buffer Acretin if you want to reduce its side effects, and have better treatment outcomes! More about this in the “How to Use” section below.
- Administration: Administered under the supervision of an experienced cancer chemotherapy physician in a facility equipped to diagnose and manage complications.
- Teratogenic effects: High risk of severe infant deformity if administered during pregnancy; if treatment with Acretin is required in women of childbearing potential, 2 reliable forms of contraception should be used during, and for 1 month after, therapy; if it is determined that Acretin represents the best available treatment for a pregnant woman, patients should be informed of the risk to the fetus.
- Retinoic acid-APL syndrome: About 25% of patients with APL treated with Acretin experience a syndrome called the retinoic acid-APL syndrome, which can be fatal and is characterized by fever, dyspnea, acute respiratory distress, weight gain, radiographic pulmonary infiltrates, pleural or pericardial effusions, edema, and hepatic, renal, and/or multi-organ failure; this syndrome has occasionally been accompanied by impaired myocardial contractility and episodic hypotension; management has not been defined rigorously, but high-dose steroids given at the first suspicion of the RA-APL syndrome appear to reduce morbidity and mortality.
- Rapidly evolving leukocytosis: About 40% of patients will develop rapidly evolving leukocytosis; those who present with high WBC at diagnosis (i.e., greater than 5 x10^9/L) have an increased risk; if signs and symptoms of the RA-APL syndrome are present together with leukocytosis, treatment with high-dose steroids should be initiated immediately.
- This medication contains Acretin. Do not take Vesanoid if you are allergic to Acretin or any ingredients contained in this drug.
- Keep out of reach of children
- In case of overdose, get medical help or contact a Poison Control Center immediately
Which drugs or supplements interact with Acretin?
Combining other topical acne medications (for example, salicylic acid) with Acretin may lead to excessive skin irritation. Use of abrasive soaps or cleansers, astringents, skin waxes and other products that irritate the skin may add to Acretin-induced skin irritation. Medications that cause sun sensitivity should not be combined with Acretin because of additive sun sensitivity.
Retin-A vs. Retin-A Micro
Retin-A and Retin-A Micro are both brand names for Acretin. The big difference between these two medications is how they deliver the Acretin to your skin. Retin-A Micro delivers the medication more slowly, over time, so it's less irritating than Retin-A.
Pregnancy Category C.
Oral Acretin has been shown to be teratogenic in rats, mice, hamsters, and subhuman primates. It was teratogenic and fetotoxic in Wistar rats when given orally or topically in doses greater than 1 mg/kg/day (8 times the maximum human systemic dose adjusted for total body surface area). However, variations in teratogenic doses among various strains of rats have been reported. In the cynomolgus monkey, which metabolically is closer to humans for Acretin than the other species examined, fetal malformations were reported at doses of 10 mg/kg/day or greater, but none were observed at 5 mg/kg/day (83 times the maximum human systemic dose adjusted for total body surface area), although increased skeletal variations were observed at all doses. A dose-related increase in embryolethality and abortion was reported. Similar results have also been reported in pigtail macaques.
Topical Acretin in animal teratogenicity tests has generated equivocal results. There is evidence for teratogenicity (shortened or kinked tail) of topical Acretin in Wistar rats at doses greater than 1 mg/kg/day (8 times the maximum human systemic dose adjusted for total body surface area). Anomalies (humerus: short 13%, bent 6%, os parietal incompletely ossified 14%) have also been reported when 10 mg/kg/day was topically applied.
There are other reports in New Zealand White rabbits administered doses of greater than 0.2 mg/kg/day (3.3 times the maximum human systemic dose adjusted for total body surface area) of an increased incidence of domed head and hydrocephaly, typical of retinoid-induced fetal malformations in this species.
In contrast, several well-controlled animal studies have shown that dermally applied Acretin may be fetotoxic, but not overly teratogenic in rats and rabbits at doses of 1.0 and 0.5 mg/kg/day, respectively (8 times the maximum human systemic dose adjusted for total body surface area in both species).
With widespread use of any drug, a small number of birth defect reports associated temporally with the administration of the drug would be expected by chance alone. Thirty human cases of temporally associated congenital malformations have been reported during two decades of clinical use of Acretin. Although no definite pattern of teratogenicity and no causal association has been established from these cases, five of the reports describe the rare birth defect category holoprosencephaly (defects associated with incomplete midline development of the forebrain). The significance of these spontaneous reports in terms of risk to the fetus is not known.
Topical Acretin has been shown to be fetotoxic in rabbits when administered 0.5 mg/kg/day (8 times the maximum human systemic dose adjusted for total body surface area). Oral Acretin has been shown to be fetotoxic, resulting in skeletal variations and increased intrauterine death in rats when administered 2.5 mg/kg/day (20 times the maximum human systemic dose adjusted for total body surface area).
There are no adequate and well-controlled studies in pregnant women. Acretin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
What are the side effects of Acretin?
Following the application of Acretin to the skin, there often is local inflammation. This reaction disappears when treatment is stopped. Mild stinging or a sensation of warmth also can occur when applying Acretin.
The common side effects of Acretin are:
Other side effects of Acretin include:
- Increased sun sensitivity
- Darkening or lightening of the skin
- Initial acne flare-up
I am always getting questions about Acretin and Retinol. What are they? How are they different? Do they really work for anti-aging? Today, I want to clear all of this up for you.
Acretin topical is a member of the topical acne agents drug class and is commonly used for Acne, Lichen Sclerosus, Necrobiosis Lipoidica Diabeticorum and others.
Brand names for Acretin topical include Retin-A, Avita, Retin A Micro, and Atralin.
Carcinogenesis, Mutagenesis, Impairment to Fertility:
In a 91-week dermal study in which CD-1 mice were administered 0.017% and 0.035% formulations of Acretin, cutaneous squamous cell carcinomas and papillomas in the treatment area were observed in some female mice. A dose-related incidence of liver tumors in male mice was observed at those same doses. The maximum systemic doses associated with the administered 0.017% and 0.035% formulations are 0.5 and 1.0 mg/kg/day, respectively. These doses are two and four times the maximum human systemic dose, when adjusted for total body surface area. The biological significance of these findings is not clear because they occurred at doses that exceeded the dermal maximally tolerated dose (MTD) of Acretin and because they were within the background natural occurrence rate for these tumors in this strain of mice. There was no evidence of carcinogenic potential when 0.025 mg/kg/day of Acretin was administered topically to mice (0.1 times the maximum human systemic dose, adjusted for total body surface area). For purposes of comparisons of the animal exposure to systemic human exposure, the maximum human systemic dose is defined as 1 gram of 0.1% Acretin applied daily to a 50 kg person (0.02 mg Acretin/kg body weight).
Studies in hairless albino mice suggest that concurrent exposure to Acretin may enhance the tumorigenic potential of carcinogenic doses of UVB and UVA light from a solar simulator. This effect has been confirmed in a later study in pigmented mice, and dark pigmentation did not overcome the enhancement of photocarcinogenesis by 0.05% Acretin. Although the significance of these studies to humans is not clear, patients should minimize exposure to sunlight or artificial ultraviolet irradiation sources.
The mutagenic potential of Acretin was evaluated in the Ames assay and in the in vivo mouse micronucleus assay, both of which were negative.
In dermal Segment I fertility studies of another Acretin formulation in rats, slight (not statistically significant) decreases in sperm count and motility were seen at 0.5 mg/kg/day (4 times the maximum human systemic dose adjusted for total body surface area), and slight (not statistically significant) increases in the number and percent of nonviable embryos in females treated with 0.25 mg/kg/day (2 times the maximum human systemic dose adjusted for total body surface area) and above were observed. A dermal Segment III study with Acretin has not been performed in any species. In oral Segment I and Segment III studies in rats with Acretin, decreased survival of neonates and growth retardation were observed at doses in excess of 2 mg/kg/day (16 times the human topical dose adjusted for total body surface area).
Acretin vs. IsoAcretin
Acretin and isoAcretin both are prescription medications used to treat acne. Both are derived from vitamin A. That's where their similarities stop.
Acretin is used topically to treat acne. IsoAcretin, better known by the now-defunct brand name Accutane, is an oral medication used to treat severe inflammatory acne. Acretin and isoAcretin are not interchangeable.
See also Precautions section.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Some products that may interact with this drug include: hair perming solutions, alcohol/lime/menthol-containing products (such as astringents, toners, shaving lotions), medicated or abrasive soaps and cleansers, products containing sulfur, resorcinol or salicylic acid, products containing alpha hydroxy acid, products containing glycolic acid, soaps and cosmetics with a strong drying effect, other drugs that may increase your sensitivity to sunlight (e.g., fluoroquinolones such as ciprofloxacin, tetracyclines, thiazide water pills such as hydrochlorothiazide, sulfa drugs such as sulfamethoxazole, phenothiazines such as chlorpromazine).
Benzoyl peroxide can be very irritating and may decrease the effectiveness of Acretin if the two products are applied at the same time. Talk with your doctor or pharmacist about the safe use of prescription and non-prescription benzoyl peroxide products (e.g., Pro-Activ, Clearasil).