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Retinoids in treatment of psoriasis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Topical retinoid treatment:

  • tazarotene (available in 0.05% & 0.1% gels or creams) is a topical retinoid licensed for the treatment of psoriasis
  • it has a relatively low efficacy
  • may cause soreness and burning
  • should not be used in pregnancy
  • as with other topical therapies, combination therapy has been tried, eg combining tazarotene with a topical corticosteroid increased efficacy while reducing the incidence of local adverse effects (1)

Oral retinoid therapy:

  • Requires dermatologist supervision
    • Acitretin is an effective oral retinoid as a monotherapy
    • long term therapy may be necessary since retinoids only suppresses the disease process
    • retinoids are potent antipsoriatic drugs for pustular and erythrodermic psoriasis but are less effective in chronic plaque psoriasis
    • when used in combination with PUVA it has been shown to reduce the required dosage (both UVA and acitretin) to achieve clearance
    • side effects - drying and cracking of lips, dryness of the nasal buccal and conjunctival mucosa, elevation of liver enzymes (20-30%) and plasma lipid levels (up to 25%)
    • due to the teratogenicity of the drug it should be avoided in pregnancy and patients should be advised not to get pregnant for a period of 2 years after stopping acitretin (3)

Consult the summary of product characteristics before prescribing this drug.


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