Trifarotene for skin

Trifarotene or Aklief (brand name) is a fourth-generation retinoid with a selective action on RAR-γ. It helps to treat acne vulgaris, photoaging, and chemo-prevention just like other retinoids. It mainly comes in the form of a cream.

• It can treat Acne Vulgaris (inflammatory lesions and non-inflammatory lesions): Topical application is shown to be safe, well-tolerated, and more effective in reducing both non-inflammatory and inflammatory lesions in acne of the face and trunk (upper back, shoulders and chest).

• It may help in the treatment of Autosomal Recessive Congenital Ichthyosis (ARCI): ARCI refers to the rare heterogeneous family of congenital diseases of keratinization linked to generalized hyperkeratosis (thickening of the outer layer of the skin), sometimes accompanied by erythroderma ( a inflammatory skin disease with redness and scaling).

• The most common subtypes include lamellar ichthyosis, congenital ichthyosiform erythroderma, and harlequin ichthyosis.

• In 2014, the FDA granted Orphan Drug Designation for the treatment of congenital ichthyosis using trifarotene. In 2016 Galderma announced that trifarotene showed success in treating lamellar ichthyosis in a phase I study. The results of the phase 2 study will be available probably by the end of the year.

• As of now, there is no treatment approved by the regulatory authorities for the treatment of this rare condition.

• It may help in the treatment of non-melanoma skin cancer: trifarotene can be used as preventive local treatment in cancerization and as a target treatment for overt NMSCs. Trifarotene can also be used alone or combined with other active compounds, but more studies are needed to prove that trifarotene can help in the treatment of NMSC.

• It may help in the treatment of Invasive Fungal Infections (IFI): trifarotene might be able to fight against respiratory and esophageal mycosis, but more studies are needed to prove this.

• It can help in the treatment of skin and nail mycosis: trifarotene can help to treat Onychomycosis (a fungal infection of finger nails).

• It may help to treat photoaging: trifarotene can also help in the treatment of photoaging (fine lines, wrinkles, dark spots, xerosis, and stimulate collagen), but more studies are needed to prove this.

• It can treat Hand-Foot Skin Reaction: It can also help in reducing HFSR and normalizing keratinization.

Trifarotene comes in the form of a cream for topical use. Apply a thin layer of the cream on the affected areas once daily, in the evening, on clean and dry skin.

• One pump actuation should be enough for the face (i.e., forehead, cheeks, nose, and chin).
• Two pumps of the cream should be enough for the upper trunk (i.e., upper back, shoulders and chest). One additional pump may be used for the middle and lower back if acne is present.

There might be purging (redness, scaling, dryness, stinging, and burning) in the 4-6 weeks of treatment when using the trifarotene cream which is normal. You should also remember to use a moisturizer to reduce the effects of purging.

Avoid applying the cream to damaged skin such as cuts, abrasions, and sunburned areas.

Other than purging, if you have an allergic reaction to the cream like hives, difficulty in breathing, swelling of face, lips, and mouth stop using the cream and consult a doctor.

• Trifarotene can make you sunburn easily. Wear protective clothing and use a sunscreen of SPF 30 or more.

• Make sure the product doesn’t get into your eyes or mouth.

• Avoid using skin products that can cause irritation (harsh soaps, cleansers, and products that contain alcohol or dry the skin).

Trifarotene cream can be used during pregnancy and breastfeeding, but do make sure to not apply the product directly to the nipple and areola. For more information, contact your doctor.

Trifarotene may be stronger than tretinoin, but tretinoin has more data and evidence to treat acne than trifarotene and is still the go-to retinoid to treat acne.

The main difference between trifarotene and tretinoin is that trifarotene is suitable for more sensitive and acne-prone skin types (it can help reduce the effects of purging and is a less stronger retinoid than tretinoin). Tretinoin is also suitable for these skin types but it is stronger and provides results faster.