Living Reference Work Entry

Daily Routine in Cosmetic Dermatology

Part of the series Clinical Approaches and Procedures in Cosmetic Dermatology pp 1-16

Date: Latest Version


  • David Rubem AzulayAffiliated withInstituto de Dermatologia Professor Rubem David Azulay/Santa Casa da Misericórdia Email author 
  • , Dâmia Leal VendraminiAffiliated withInstituto de Dermatologia Professor Rubem David Azulay/Santa Casa da Misericórdia


Retinoid includes all natural or synthetic compounds based in vitamin A (Vit. A) similar activity, thereby has the ability to activate nuclear retinoid receptors. Through the discovery of nuclear receptors for retinoic acid, greater understanding of mechanism of action of these compounds was achieved. Such advance allows also the possibility of development of molecules with specific roles in various pathological affections that are the cause of many diseases.

These receptors are coupled to certain regions of DNA that are responsive to activation by retinol and/or retinoic acid. Subsequently, the message is transcribed (messenger RNA) to ribosomes, where proteins are synthesized. Therefore, they end up acting at the cellular differentiation, embryonic morphogenesis, and carcinogenesis.

Retinoids are classified into generations. The first generation: retinoic acid (RA), tretinoin or acid vitamin A, alitretinoin (9 cis-retinoic acid), and isotretinoin (13 cis-retinoic acid). They are all isomers and naturally occur in the organism.

Acitretin and its precursor etretinate are the second-generation retinoids.

The more recent third generation is represented by adapalene, tazarotene, motretinide, and arotinoides.

Retinoids have a large number of indications. According to the indication, their use can be topical or systemic. Their benefits range from anti-inflammatory action, immunomodulatory effects, and more recently of photoaging.

A huge list of possible adverse effects must be known in order to minimize the risk. They are essentially dose dependent.


Retinoids Retinoic acid Tretinoin Vitamin A 9 cis-retinoic acid Acitretin