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Topical Retinoid — Psoriasis / Acne Pregnancy: Contraindicated in pregnancy — tazarotene is a teratogenic retinoid and may cause fetal harm; discontinue as soon as pregnancy is recognised. Females of childbearing potential should have a negative pregnancy test within 2 weeks prior to initiating treatment and use an effective method of contraception during treatment.

Tazarotene

Brand names: Zorac (psoriasis), Twyneo (acne — newer combined formulation)

Tazarotene is a topical retinoid used for mild-to-moderate plaque psoriasis and for acne.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Apply a thin film (2 mg/cm²) of tazarotene cream to cover only the affected area
Route: Topical (cutaneous)
Frequency: Once daily, in the evening
US prescribing information (TAZORAC Cream, Almirall LLC, label date 2025-11-13) — no UK SPC was retrieved, so verify against UK labelling before publishing. PSORIASIS (§2.2): treatment should start with tazarotene cream 0.05%, with the strength increased to 0.1% if tolerated and medically indicated; apply once per day in the evening to cover only the psoriatic lesions. If a bath or shower is taken beforehand the skin should be dry before applying; if emollients are used they should be applied at least an hour before the cream. Unaffected skin may be more susceptible to irritation, so application to those areas should be carefully avoided. ACNE (§2.3): cleanse the face gently and, once the skin is dry, apply a thin layer (2 mg/cm²) of the 0.1% cream once per day in the evening to the areas where acne lesions appear, using enough to cover the entire affected area; use effective sunscreens and wear protective clothing. For topical use only — not for ophthalmic, oral or intravaginal use; if contact with eyes or mucous membranes occurs, rinse thoroughly with water. Wash hands thoroughly after application. Should not be used on eczematous skin (may cause severe irritation); if excessive pruritus, burning, redness or peeling occurs, discontinue until skin integrity is restored, reduce the dosing interval, or in psoriasis switch to the lower concentration. Strengths: 0.05% cream = 0.5 mg tazarotene per gram; 0.1% cream = 1 mg per gram. PAEDIATRIC: safety and efficacy not established under 18 years in psoriasis, or under 12 years in acne.

Dose auto-extracted from US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

  • Pregnancy — retinoids may cause fetal harm when administered to a pregnant female
  • Known hypersensitivity to any of its components

Side effects

  • Plaque psoriasis (10–23% of patients): pruritus
  • Plaque psoriasis: erythema
  • Plaque psoriasis: burning
  • Acne vulgaris (10–30% of patients): desquamation and dry skin
  • Acne vulgaris: erythema and burning sensation
  • Photosensitivity and risk of sunburn

Interactions

  • No formal drug-drug interaction studies have been conducted with tazarotene cream
  • Oral tazarotene 1.1 mg did not affect the pharmacokinetics of a combined oral contraceptive (norethindrone 1 mg with ethinylestradiol 35 micrograms) over a complete cycle; the impact on progestogen-only oral contraceptives has not been evaluated
  • Administer with caution in patients also taking drugs known to be photosensitisers (§5.3)

Clinical monograph

How it works

As a receptor-selective retinoid it binds retinoic acid receptors to normalise keratinocyte differentiation and proliferation and exert anti-inflammatory effects in the skin.

Prescribing in practice

  • Contraindicated in pregnancy and in women planning pregnancy because of the teratogenic potential of retinoids, so effective contraception is required.
  • Apply sparingly to plaques only, avoiding healthy skin, flexures, the face and eyes to limit irritation.
  • Skin irritation is dose-related and patients should minimise sun exposure and use sun protection.

Monitoring

No routine bloods are required; monitor for local irritation and review treatment response, and confirm pregnancy status where relevant.

Counselling the patient

  • Do not use if pregnant, breastfeeding or trying to conceive, and use reliable contraception.
  • Apply a thin layer to the plaques only and protect surrounding skin.
  • Redness, burning and dryness are common, especially early in treatment, and sun protection should be used.

Evidence & guidelines

Topical tazarotene is an established option for localised plaque psoriasis and acne, supported by randomised controlled trial evidence.

Reference: BAD Psoriasis Guidelines 2017; BAD Acne Guidelines 2020; NICE NG198; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.