How Does Tazarotene Work?

Tazarotene is a relatively new prescription retinoid, and it is used to treat acne vulgaris, psoriasis, and other skin concerns.  How does tazarotene work, what is it used for, and what are the potential benefits and side effects?

What is tazarotene?

Tazarotene, also known as Tazorac, is a prescription topical cream that comes in 0.05% and 0.1% strengths.¹  Tazarotene is approved by the FDA as a treatment for plaque psoriasis as well as acne vulgaris.¹  Plaque psoriasis is a common type of psoriasis, and it is a chronic inflammatory condition that causes scaly, potentially uncomfortable, patches on the surface of the skin.²

Tazarotene is a third-generation topical retinoid, and it works similarly to other topical retinoids such as tretinoin and adapalene.  However, it is unique in that it is also FDA-approved for the treatment of plaque psoriasis, whereas tretinoin and adapalene are not. 

Some evidence suggests that it might be more effective than other retinoids in treating acne vulgaris.  For example, one study found that patients with moderate-to-severe acne that applied tazarotene 0.1% cream daily for 16 weeks exhibited a greater improvement in acne lesions than those who used 0.3% adapalene cream.³  However, another study found that there was no significant difference in efficacy between the two retinoids, so more research is needed to determine this.⁴ 

Tazarotene could potentially be more irritating than adapalene; common side effects of topical prescription retinoids may include irritation, dryness, redness, and flaking, and there is evidence that suggests that there might be a difference in the severity of these side effects between the two.  For example, one study found that participants tolerated adapalene 0.3% gel better than tazarotene 0.1% gel, and fewer adverse side effects were reported.⁵  However, different people respond differently to different treatments, and more research is needed to determine whether these claims are significant.

How does tazarotene work?

The exact mechanism of tazarotene is unknown; however, current research suggests that it can induce a variety of potential changes by binding to nearby retinoic acid receptors in the skin.⁶  This is thought to help acne by increasing the rate of skin cell turnover as well as reducing the risk of a buildup of keratin in the sebaceous ducts.⁷ 

Tazarotene also seems to reduce inflammation in a variety of studies, and this could potentially contribute to its therapeutic effect against psoriasis given that psoriasis is an inflammatory and immune-system-mediated condition.⁸  The mechanism for this is unknown, and more research is needed to determine the effects that tazarotene might have on the inflammatory response and immune system, if any.  Tazarotene is also thought to decrease the risk and severity of skin atrophy and side-effects associated with topical corticosteroids, which are often prescribed to treat plaque psoriasis.⁸ 

What are the side effects of tazarotene?

For some people, tazarotene may have similar side effects to those of other topical retinoids, such as excessive skin dryness, flaking, redness, and irritation.⁸  Using tazarotene may also be associated with increased sensitivity to UV radiation, so it is especially important to limit sun exposure and use broad-spectrum sunscreens that protect against UVA and UVB radiation. 

It is important to tell your doctor or another healthcare provider about any side effects you are concerned about; they may want to alter the strength of the medication or discontinue it altogether.  Moreover, tazarotene should not be used by individuals who are allergic to tazarotene.  Seek medical help immediately if you experience signs of an allergic reaction after using the medication, such as hives, chest tightness, and swelling of the face, mouth, or throat.

Orally-taken retinoids, such as isotretinoin (Accutane) are not recommended for use during pregnancy due to their potentially teratogenic effects.⁹  Using topical tazarotene is associated with minimal absorption of the medication into the bloodstream; however, the blood concentration associated with teratogenicity is not known.¹⁰  For this reason, tazarotene is not recommended for use during pregnancy.¹⁰ 

Some topical medications and oral medications may interact with tazarotene, so it is important to tell your doctor or healthcare provider about all products, supplements, and medications you may be using.  This article is not medical advice, and it is not intended to prescribe, diagnose, or promote specific treatments for any condition.  Consult your doctor or another qualified provider for your unique needs.

References

1. Access Data FDA (2013, December). Full Prescribing Information. Allergan, Inc; Irvine, CA 92612: Accessed 2021, May 19, from https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/021184s007lbl.pdf
2. Badri, T., Kumar, P., Oakley, A.M. (2020, August 10). Plaque Psoriasis. StatPearls [Internet]. Accessed 2021, May 19, from https://www.ncbi.nlm.nih.gov/books/NBK430879/
3. Tanghetti, E., Dhawan, S., Green, L., et al (2010, May). Randomized comparison of the safety and efficacy of tazarotene 0/1% cream and adapalene 0.3% gel in the treatment of patients with at least moderate facial acne vulgaris. J Drugs Dermatol 9(5): 549-558. Accessed 2021, May 19, from https://pubmed.ncbi.nlm.nih.gov/20480800/
4. Pariser, D., Colon, L.E., Johnson, L.A. (2008, June). Adapalene 0.1% gel compared to tazarotene 0.1% cream in the treatment of acne vulgaris. J Drugs Dermatol 7(6 suppl): s18-23. Accessed 2021, May 19, from https://pubmed.ncbi.nlm.nih.gov/18575222/
5. Thiboutot, D., Arsonnaud, S., Soto, P. (2008). Efficacy and tolerability of adapalene 0.3% gel compared to tazarotene 0.1% gel in the treatment of acne vulgaris. J Drugs Dermatol 7(6 suppl): s13-s10. Accessed 2021, May 19, from https://pubmed.ncbi.nlm.nih.gov/18575220/
6. Chandratatna, R.A. (1997, August). Tazarotene: the first receptor-selective topical retinoid for the treatment of psoriasis. J Am Acad Dermatol 37(2 part 3): s12-17. Accessed 2021, May 21, from https://pubmed.ncbi.nlm.nih.gov/9270551/
7. Gregoriou, S., Kristotaki, E., Katoulis, A., et al (2014). Use of tazarotene foam for the treatment of acne vulgaris. Clin Cosmet Investig Dermatol 7: 165-170. Doi: 10.2147/CCID.S37327
8. Dando, T.M., Wellington, K. (2012, August 21). Topical Tazarotene. Adis Drug Evaluation 6: 255-272. Doi: 10.2165/00128071-200506040-00006.
9. Tang-Liu, D.D., Matsumoto, R.M., Usansky, J.I. (1999, October). Clinical pharmacokinetics and drug metabolism of tazarotene: a novel topical treatment for acne and psoriasis. Clin Pharmacokinet 37(4): 273-287. Doi: 10.2165/00003088-199937040-00001.
10. Han, G., Wu, J.J., Del Rosso, J.Q. (2020, September). Use of topical tazarotene for the treatment of acne vulgaris in pregnancy: a literature review. J Clin Aesthet Dermatol 13(9): E59-65. Accessed 2021, May 21, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7577328/
11. Image by Joseph Mucira from Pixabay