Acitretin - Characteristics, Indications, and Uses

06 February, 2020
Acitretin acts by inhibiting the overgrowth of cells and keratinization of the skin. Continue reading to learn more about this retinoid, its indications, and its contraindications.
 

Acitretin is a drug that belongs to the group of retinoids or derivatives of vitamin A. Thus, it’s an aid in the treatment of problems that thicken the skin and give it a scaly appearance.

This medication works by inhibiting cell overgrowth and the keratinization of the skin. Keratinization is a process by which skin cells thicken due to the deposition of proteins on them.

What’s Acitretin for?

An illustration of psoriasis.

Acitretin is used in the treatment of severe and widespread forms of skin conditions. Psoriasis is one of these generalized conditions. It’s also helpful in the treatment of ichthyosis. This is a skin disorder in which keratin deposits in the cells and hardens them. This is similar to nails and hair.

You should only take this drug under medical supervision, preferably from a dermatologist. This is because these specialists, in particular, have more experience in treatment with systemic retinoids.

Routes of administration

You must take Acitretin with food or milk. As for the dose, it varies from patient to patient. You should always follow the guidelines prescribed by your doctor.

The usual starting dose for adults and the elderly is 25 mg or 30 mg, once daily. However, after 2-4 weeks, it’s possible for your doctor to change the dose depending on the effectiveness and its effect on you.

 

In any case, the maximum dose is 75 mg per day, and the treatment will last a maximum of three months. However, it can go on longer if the specialist finds it necessary.

Don’t try to make up for your daily dose if you forget to take it. However, do take it as soon as possible. However, you shouldn’t take it if there’s little between the one you missed and the next one. You must consult your doctor if you wish to discontinue treatment, so don’t do it on your own.

Discover: Foods that Can Help Control Psoriasis

Side effects

A person about to take a pill.

Like all medications, Acitretin can also lead to side effects. They’re usually dosage-related. The higher the daily dose, the greater the risk.

Most of the side effects appear when you begin treatment and go away if you modify or interrupt the dose.

Dry skin, mucous membranes, and lips are among the most common adverse effects. In addition, there may be other unwanted effects, such as:

  • Changes in the growth rate and texture of the hair
  • Inflammation of gums and oral mucosa
  • Skin blisters and cracks
  • Color changes in your hair and skin
  • Visual disorders, such as dry eyes, blurred vision, poor night vision, and contact lens intolerance
 

In other cases, in addition to the dryness of mucous membranes in the skin and nose, there is peeling of the skin. The peeling may specifically appear in the palms of your hands and the soles of your feet.

A smaller percentage of patients showed side effects such as nosebleeds. They also had a scaly skin appearance and there was a thinning of healthy skin, with increased sensitivity.

When the long-term treatment with acitretin is over, there may be bone changes such as bone thinning or reduction in bone density — osteoporosis.

When should Acitretin not be used?

You shouldn’t use Acitretin in the following situations:

  • If you’re pregnant or may become pregnant during treatment or in the subsequent 3 years
  • If you have a hepatic, renal or coronary insufficiency
  • Allergic to Acitretin or any retinol derivatives
  • If you’re undergoing a tetracycline treatment

Read also: Five Ways to Keep Psoriasis at Bay

You must know and keep in mind that Acitretin is highly teratogenic. That is, it can trigger fetal malformations in pregnant women if they undergo treatment with it. Typical Acitretin malformations include:

  • Damage to the central nervous system
  • Heart problems and dilated blood vessels
  • Deformations in the skull, face, and skeleton
  • Problems in the thymus gland

The proportion of malformations is high, even when a pregnant woman only takes it for a short period of time. It can also happen if pregnancy occurs within the 3 years after ending treatment.

 

Conclusion

You should always use Acitretin under medical supervision and be particularly careful if you’re a woman. Don’t take this drug if you are pregnant or plan to become pregnant within the next 3 years. As we said above, this medication leads to major fetal malformations.

  • Carretero, G., Ribera, M., Belinchón, I., Carrascosa, J. M., Puig, L., Ferrandiz, C., … Moreno, J. C. (2013). Acitretina: guía de uso en psoriasis. Actas Dermo-Sifiliográficas. https://doi.org/10.1016/j.ad.2013.01.003

  • Höpker, L. M., Ribeiro, C. G., Oliveira, L. M., & Moreira, A. T. R. (2011). Ichthyosis follicularis, alopecia and photophobia syndrome (IFAP): Report of the first case with ocular and cutaneous manifestations in Brazil with a favorable response to treatment. Arquivos Brasileiros de Oftalmologia. https://doi.org/10.1590/S0004-27492011000100013

  • Medina, S., & Ledo, A. (1992). RETINOIDES. Monografias de Dermatologia.