To Tazorac or not and how to use it for comedonal acne and anti-aging? (Photos)

Question

Since 40 my skin is breaking out again. Mostly comedonal non inflamed acne on my face & upper trunk. I’m also looking to correct lines, spots, texture & scars. The most recent derm prescribed me .05 as a compounded version of Tazorac with niacinamide. I’ve read great/ horrible stories about Tazorac. Any advice would be greatly appreciated on how to ease my skin into it. Or if I should even use it at all. Is There an initial break out? How long does it take to work? My skin is very sensitive.

Amy Y. Paul, DO, FAAD · Answer

Tazorac is the strongest synthetic retinoid.  The regular retinoids are the retin-a family, and the weakest synthetic is Differin which is an over the counter.  If you live somewhere with a lot of humidity and have fairly oily skin, you will probably tolerate the Tazorac well.  If your climate is dry, you can start with once or twice a week bedtime use and increase frequency as your skin gets used to the Tazorac.   My practice is in Colorado, where the air is dry and lacks humidity.  I can almost never get patients to tolerate Tazorac, so we use Retin-a or generic Tretinoin of various concentrations for aging skin and acne control.  See your board certified dermatologist, who will likely recommend more than just topicals if you are really having trouble with breakouts.  Sprionolactone is a low-cost, low-risk medication that can complement acne treatment in adult women, including those using a retinoid.  Best of luck.

Emil A. Tanghetti, MD · Answer

Topical retinoids, like tazarotene, have great benefits for treating acne and photodamage but getting over the initial irritation can often be difficult for some patients, which may be the source of some of the negative feedback you've heard about these products. . It's quite common to experience some dryness and irritation when you first start using topical retinoid products such as Tazorac. Proper education on the use of these products is critical to help with these side effects. For my patients, I recommend the following. Use a non-soap and non-irritating cleanser such as Cetaphil or Cerave and wash with luke warm or cold water. Use a good moisturizer in conjunction with the Tazorac. Given that you are acne prone, looking for a non-comedogenic moisturizer would be prudent.  You may also want to try using the Tazorac every other night or every third night and slowly build up to every night as your skin starts to tolerate the product better. These tips should help mitigate the initial side effects from the product.

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

Thank you for your question and photographs.Tazorac is an effective treatment, but side effects of dryness and irritation is common. Some individuals cannot tolerate Tazorac. With that being said, I generally recommend to start retinoids every other night or for sensitive skin, 2 times a week. Then if there are no side effects, slowing increase the frequency. I highly recommend you consult with a board certified dermatologist regarding any further questions about your treatment. Take care and good luck.

To Tazorac or not and how to use it for comedonal acne and anti-aging? (Photos)

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