Trifarotene

How it works

It is a selective retinoic acid receptor (RAR) gamma agonist that normalises follicular keratinisation and has anti-inflammatory effects, helping to prevent comedone formation.

Prescribing in practice

• Topical retinoids are contraindicated in pregnancy and should be avoided when trying to conceive; counsel women of childbearing potential about effective contraception.
• Local skin irritation, dryness, erythema and photosensitivity are common, particularly early in treatment.
• Apply a thin film to clean dry skin in the evening and avoid contact with eyes, lips and mucous membranes as described in the SPC.

Monitoring

Review tolerability and treatment response at follow-up, reducing application frequency if irritation is troublesome.

Counselling the patient

• Use sunscreen and limit sun exposure, as your skin will be more sensitive to sunlight.
• Some redness, peeling and dryness is expected at first; use a non-comedogenic moisturiser.
• Do not use if you are pregnant or planning pregnancy.

Evidence & guidelines

Topical retinoids are established first-line agents for acne in NICE guidance, and trifarotene's efficacy is supported by randomised controlled trials in facial and truncal acne.