Drawbacks

Topical use of retinoid acid plus steroids is reported to cause significantly more subjective irritation than topical steroids without retinoic acid.31 Frequent side-effects such as dryness of the mucosae and lips, but also loss of hair and universal pruritus were reported for the treatment with etretinate.32 Oral 9-c/s-retinioic acid showed fewer and milder side-effects: cheilitis, 29%; headache, 11%; flush, 11%; conjunctivitis, 3%.33

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Oral 9-cZs-retinioic acid seems to be a promising option but evidence of a comparative advantage

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