Coman GC, Holliday AC, Mazloom SE, et al. Br J Dermatol. Epub 27 October 2016. Accepted Author Manuscript. doi:10.1111/bjd.15150. http://onlinelibrary.wiley.com/doi/10.1111/bjd.15150/full
Topical retinoids are first line medications in acne treatment but are limited by erythema, scaling, dryness, and initial worsening of acne, which contribute to discontinuation. We sought a pharmacologic strategy to decrease irritation and quicken the onset of action attempting to increase compliance.
Topical corticosteroids (TCS) are commonly used for their anti-inflammatory properties, but are generally avoided on the face to prevent skin atrophy and acne induction.3 We believed TCS could be used on the face in acne patients to reduce the initial irritation from tretinoin without exacerbating acne because topical tretinoin clears oral corticosteroid-induced acne.4 Since irritation is less common after 3-4 weeks, the TCS can be withdrawn within a month.