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Tretinoin generic brands and all of the brand names retinoids, amount is very insignificant in the total retinoid usage because of this fact, and there is no justification for any other prescription to have a larger quantity of retinoids for the same reason. majority of acne patients have not experienced problems from the use of high doses retinoids for a long period of time. The most often reported side effects of retinoids appear in patients who do not have acne, are using retinoids only occasionally, or who have had acne in the past but have not had any problems since discontinuing use. The use of an effective topical regimen with no additional drug therapies increases patients' compliance to the recommended regimen. Patients should be encouraged to reduce any additional cosmetics and other drug use, not only before treatment start, but after ends and when using the acne products. In most patients, the frequency of application retinoids is reduced while using an effective topical regimen (Fig 18). Figure 18. View largeDownload slide Side effects of retinoids Possible side effects of retinoids include: irritation and of the skin, which can sometimes be difficult to avoid; severe redness or irritation of sensitive skin and the surrounding skin; increased sensitivity to the sun or sunlight; redness and peeling of skin caused by exposure to the sun; and irritation of eyes eyelids when applying retinoids, even at low concentrations. There is no evidence suggesting that retinoids cause harm to the eye or eyelids. Retinoids cause irritation and can increase the number of comedones on skin surface. The amount of retinoids used should be carefully weighed against the amount of retinoids that have been absorbed. If patients are receiving daily or even multiple doses of retinoids over a long time for acne treatment, the effect on absorption should be evaluated. Acne-associated skin eruptions also occasionally occur when topical retinoids are used can you buy unisom in the uk in an excessive way for long periods of time. Although there have been few reports of such eruptions, it may be an indication that a patient needs retinoid therapy on a reduced or less frequent basis. When it is suspected or confirmed, this should be documented as a warning to the acne patient about potential risks associated with excessive topical use. Acne patients on retinoids should follow the dosing instructions provided by product's manufacturer so that treatment is started at the lowest level appropriate for condition being treated, taking into consideration the patient's individual need, age, severity, and presence or absence of comedones scarring on the skin surface. Acne patients with moderate to severe acne should be observed while they are on their prescription medication, to ensure that it is not interfering with the effective use of medication. These patients need to be monitored for their appearance and assessment to be sure that there are no problems while they on their prescription and when they use topical retinoids. The recommended regimen should provide complete control of the skin, especially acne-causing skin lesions. Patients on retinoids should not use any other acne therapies until they become completely comfortable using retinoids at reduced doses of treatment on nonacne-associated skin. Retinoids not provided by the patient's prescription should be avoided. When retinoid use is stopped, the patient should be given information about the need to discontinue use of other therapies. As with the recommendation regarding first day of treatment, retinoid use should be followed up as needed to ensure maximum effectiveness while avoiding side effects. Patients may have a good reason to use retinoids for treatment of other skin conditions after starting their acne treatment. Patients should be informed of the benefits they may experience from using other acne treatment methods and, if indicated, should be monitored to certain that such additional treatment is not causing or may cause undesirable irritation of the skin. Summary Most acne lesions are caused by a combination of genetic factors and external factors, including physical social conditions such as poverty; stress on the skin; inadequate sleep at night; lack of exercise; and a family history of acne. For the treatment mild to moderate acne, a highly effective acne therapy including the prescription of topical retinoids, should be instituted. The optimal dosage and frequency of application retinoids for treating mild-to-moderate acne depends on the severity of acne lesions. The frequency and amount of retinol retinyl palmitate applied to the skin as well frequency of the number times acne patient uses the prescription retinoid product is very important in acne management. If a patient is experiencing moderate-to-severe improvement in the condition, then there is no need to increase their use of retinoids. However, if the acne patient is not doing better during their initial treatment.

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