Topical tretinoin for rosacea: a preliminary report

Abstract

Nineteen adult women with stubborn papulo-pustular rosacea received low-strength 0.025% tretinoin cream (Retin-A, Johnson & Johnson) for 6 to 12 months. This dosage was surprisingly well tolerated, with only one dropout after 2 weeks. Although the response was slow, half the subjects achieved nearly complete clearing, which persisted for 6 months after stopping tretinoin. An unexpected and unprecedented finding was lessening of erythema and partial to complete disappearance of telangiectasia. Tretinoin has not previously been tried in rosacea, probably because of the prevailing notion that the main or sole action is comedolytic; comedones of course are lacking in rosacea. On the other hand, photodamage is an invariable feature of the disease and tretinoin has been shown to improve actinically damaged facial skin. Moreover, the ability of tretinoin to suppress inflammation may also be an ameliorating factor.