Medical Health Encyclopedia

Side Effects. They include the following:

• Calcipotriene causes skin irritation in about 20% of patients, particularly on the face and in skin folds. In fact, it causes greater skin irritation than potent corticosteroids. Diluting the drug with petrolatum or applying topical corticosteroids to sensitive areas may prevent this problem.
• Although the drug appears to be safe and effective in children, there is some concern that it may lower levels of vitamin D to the extent that it could affect bone growth. More studies are needed to assess this effect.
• There have been some reports of hypercalcemia (excessive levels of calcium in the blood) in some people who apply it to large areas.

Topical Retinoids

Retinoids are vitamin A derivatives and are being used for various skin disorders. Tazarotene (Tazorac) is the first topical retinoid found to be effective for mild to moderate psoriasis. It is available in cream or gel from.

Benefits. Tazarotene benefits the targeted skin tissue without causing the adverse systemic effects of oral retinoids. Also unlike steroids, patients do not develop thinning of the skin or tolerance to the drug. Only a very small amount is needed on each lesion. It can be used on the scalp and nails, but it is not recommended for the genital areas or around the eyes. The gel should be used on only 20% of the body at anytime, the cream on up to 35%. (As a way of measuring, the palm of the hand is about 1% of the body surface.)

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Side Effects. Tazarotene can cause dryness and irritation, including on normal skin. Applying zinc oxide around the treated area can protect the healthy skin. Using a moisturizer can help reduce dryness. At levels high enough to be effective for psoriasis, tazarotene can cause severe skin irritation. This agent, then, is usually used in combination with other treatments, therefore allowing a lower dose. Mixing the drug in equal amounts with petroleum jelly (Vaseline) initially and then gradually increasing the amount of tazarotene may help the skin areas become less sensitive. It should be noted that the skin can become very red while it is actually improving.