Features | November 2020 Tazarotene Lotion for Acne Tazarotene Lotion 0.045% offers dermatologists a new option that is effective and well tolerated for treating acne.
Arazlo (tazarotene) Lotion 0.045% (Ortho Dermatologics), now available commercially to health care professionals in the US, is the first tazarotene acne treatment available in lotion formulation and is Indicated for patients nine years of age and older. FDA approval was based on data from two Phase 3 multicenter, randomized, double-blind, vehicle-controlled clinical trials in 1, 614 patients with moderate to severe acne. In both Phase 3 studies, all primary efficacy endpoints were met with statistical significance (p<.001). ARAZLO was also shown to be generally well-tolerated in the clinical study population. Ahead, lead Arazlo study investigator Emil Tanghetti, MD shares insights on this new treatment.
Dr. Tanghetti: Tazarotene is recognized as the most efficacious topical retinoid to treat acne. What differentiates Arazlo from the other forms of this agent in the marketplace is the unique vehicle, which combines moisturizing agents that lubricate the skin while treating acne. This combination of the drug and its novel delivery system provides excellent efficacy with minimal to no irritation in an aesthetically pleasing, highly spreadable lotion.
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This advanced vehicle permits the delivery of tazarotene to the skin at half the concentration in the traditional cream formulations. This unique polymeric vehicle separates moisturizing agents and active drug which then mix instantaneously when this system is applied and is dissolved by the salts on the surface of the skin. Arazlo provides equivalent efficacy and less irritation. In the past, we would have patients apply moisturizers before the application of tazarotene cream to reduce irritation. With Arazlo, this is no longer needed, ensuring better compliance and enhanced tolerability.
Dr. Tanghetti: All patients with acne, especially adult females, are ideal candidates for treatment. Adult female patients demand a product that is moisturizing, but not greasy, with a good tolerability profile. There are studies with tazarotene in photodamaged skin with improvement in fine lines, wrinkles, mottled hyperpigmentation, and solar elastosis. These factors make this product particularly appealing to women with adult acne.
Dr. Tanghetti: All retinoids generally take eight to 12 weeks to see significant improvement, with best results seen at 16 to 24 weeks. Patients generally use this product often in combination with a benzoyl peroxide/clindamycin gel applied in the morning. Generally patients are using the product as long as they have acne. Many of my adult female patients continue treatment with this agent for many years.
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As with any retinoid, some irritation can be seen. This formulation of its polymeric vehicle, which releases light moisturizers during the application of the active agent, is in my experience an agent that has significantly less irritation than any of the other retinoids in the marketplace.
Dr. Tanghetti: My patients are elated with the results of this product. There is virtually no irritation seen. They are impressed with the spreadability and aesthetic properties of the lotion. They also notice an improvement in the aesthetic appearance of their skin, with respect to the signs of photo-aging.
Dr. Tanghetti: As with all retinoids, I highly recommend non-soap cleansers, use of moisturizers, and the avoidance of toners and astringents or other products that can dry the skin, such as salicylic acid. We also recommend the use of mineral-based sunscreens and urge our patients to avoid chemical sunscreens, particularly those containing avobenzone.
Figure 2 From Topical Tazarotene Gel, 0.1%, As A Novel Treatment Approach For Atrophic Postacne Scars: A Randomized Active Controlled Clinical Trial
As mentioned earlier, the efficacy can also be enhanced with the use of other agents, generally in the morning, such as benzoyl peroxide/clindamycin, topical dapsone, and some of the other agents which address acne with a different mechanism of action than a topical retinoid.
Dr. Tanghetti: Maintenance therapy is a critical component of controlling acne. This is a condition that will last for many years in a teenager and in adults will generally last their entire life. As such, these patients generally use products such as Arazlo for many years. Products such as Arazlo have a record of safety over many years with data also suggesting an improvement in sun damaged skin and other hallmarks of skin aging.
Dr. Tanghetti is founder of the Center for Dermatology and Laser Surgery in Sacramento, CA. He is a fellow of the American Academy of Dermatology and the American Society for Laser Medicine and Surgery.This medication is used to treat certain skin conditions, including psoriasis and acne. Different brands, dosage forms, and strengths are approved for different uses, so be sure to check the uses for your brand, dosage form, and strength of this medication. Tazarotene is a retinoid product related to Vitamin A. It is thought to work by affecting skin cell growth. For the best effect, this medication should be used with a total skin care program.
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Read the Patient Information Leaflet if available from your pharmacist before you start using tazarotene and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
This medication is for use on the skin only. Wash and dry your hands before applying the medication. Apply this medication to the skin as directed by your doctor, usually once daily at bedtime. Wash your hands after applying, unless you are treating your hands for psoriasis. If this medication accidentally gets on areas you do not need to treat, wash it off to help prevent skin irritation. Do not apply this medication to skin that is cut, scraped, sunburned, or affected by certain other skin conditions (eczema, seborrheic dermatitis). Avoid getting this medication in your eyes, mouth, or on your eyelids or lips. If this happens, rinse right away with plenty of cool water.
If you are using a product that is for treating psoriasis, apply a thin film to cover only the psoriatic plaques. If a bath or shower is taken before application, make sure skin is dry before applying. If a moisturizer is used, apply it at least an hour before applying this medication.
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If you are using a product that is for treating acne, wash and dry the affected area(s). After skin is dry, apply a thin film to acne. If you are using the lotion to treat acne on the face, dot onto the chin, cheeks, nose, and forehead, then gently rub over the entire face. Use enough to cover all of the affected area(s). If you are also using other acne medication (such as benzoyl peroxide) on your skin, apply one product in the morning and one product in the evening to separate the application times. If a moisturizer is used, make sure to allow skin to dry before applying either the moisturizer or tazarotene.
If you are using the foam, shake the can before each use. The foam is flammable. Avoid smoking or going near an open flame while applying the medication.
Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time each day.
Dr. Christopher Zachary
Do not use large amounts or apply this medication more often than directed, or use it for longer than prescribed. Your condition will not improve faster, and your risk of side effects will increase.
Since this drug is absorbed through the skin and may harm an unborn baby, women who are pregnant or who may become pregnant should not handle this medication.
Itching, redness, irritation, burning/stinging, scaling, dry skin, or pain at the application site may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.
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Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
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In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Before using tazarotene, tell your doctor or pharmacist if you are allergic to it; or to vitamin A-related drugs (other retinoids such as isotretinoin); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
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Before using this medication, tell your doctor or pharmacist your medical history, especially of: other skin conditions (such as eczema, seborrheic dermatitis, sunburn, sun sensitivity).
This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen daily and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness. Wait until your skin has completely recovered from a sunburn before using this medication. Wind or cold weather may also be irritating
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