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Tazorac: 7 things you should know

Medically reviewed by Carmen Fookes, BPharm. Last updated on Nov 19, 2020.

1. How it works

  • Tazorac is a brand (trade) name for tazarotene which is a topical retinoid used for the treatment of acne or psoriasis.
  • Tazarotene is a prodrug that is converted to its active form in the body, tazarotenic acid. Tazarotenic acid binds to all three members of the retinoic acid receptor (RAR) family: RARα, RARβ, and RARγ, but shows relative selectivity for RARβ, and RARγ and may modify gene expression. By binding to these receptors, retinoids can slow the overproduction of skin cells, reduce the size and thickness of skin plaques, promote the shedding of dead skin cells, reduce dryness and flaking, and improve the overall skin appearance. Retinoids also have a role in immune modulation, are anti-inflammatory, and activate tumor suppressor genes.
  • Tazorac belongs to the class of medicines known as retinoids. Specifically, it is a third-generation poly-aromatic retinoid.

2. Upsides

  • Tazorac may be used to treat plaque psoriasis that affects up to 20% of the body surface area (BSA) in adults and children.
  • Tazorac may also be used to treat mild-to-moderate facial acne in adults and children over the age of 12.
  • Tazorac is available as a 0.05% and 0.1% gel, and an 0.05% and 0.1% cream.
  • For adults and children aged 12 and older with plaque psoriasis, the 0.05% gel is approved; the higher strength gel (0.1%) and the cream (0.05%) is only approved in adults over the age of 18 years with plaque psoriasis.
  • For adults and children aged 12 and older with acne, the 0.1% gel and 0.1% cream are both approved.
  • Unlike most corticosteroid creams, the 0.1% formulation is safe to use on the face.
  • May be used as maintenance therapy once the acne or psoriasis has been brought under control because it has fewer long-term side effects.
  • Tazorac makes your skin sensitive to sunlight, which may increase the risk of sunburn; however, it can also make phototherapy for psoriasis more effective.
  • May be given in combination with oral or injected drugs for psoriasis. It is usually combined with a topical steroid or vitamin D derivative.
  • Tazorac cream is available as a cost-saving generic under the name tazarotene.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

  • Itching, burning, stinging, dryness and flaking, skin redness, sun-sensitivity, and skin pain are the most common side effects reported, affecting 10% to 30% of users. Some people may also experience a short-term worsening of their psoriasis symptoms.
  • Tazorac is generally only used if topical corticosteroids fail to provide relief or cause serious side effects.
  • Tazorac should not be applied to areas of the skin with eczema, as this can cause severe irritation.
  • Tazorac may make people's skin more sensitive to the sun, wind, or cold, and more likely to be irritated.
  • Tazorac must not be used by women who are pregnant or planning a pregnancy as there is a risk of fetal harm. It is unsure what effects Tazorac has on a breastfeeding infant.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

Tazorac is a topical retinoid that may be used for the treatment of acne or psoriasis. Itching, burning, stinging, dryness and flaking, and skin redness are the most common side effects reported. Although Tazorac may start to have an effect within one to two weeks, it may take up to 24 weeks before the full effects are seen.

5. Tips

  • Apply Tazorac once daily as directed by your doctor. Apply thinly, never exceed the stated dose, and only apply to the affected areas of your body, not to the surrounding skin.
  • Tazorac should be applied to dry skin. If you have just taken a bath or shower, make sure your skin is dry before applying the Tazorac. before using for acne, wash the face gently then dry gently before applying in the evening to the skin areas where acne lesions appear. Avoid applying Tazorac to skin that is unaffected by acne or psoriasis.
  • To avoid irritating the surrounding skin, consider applying a barrier of petroleum jelly around the border of the plaque. Call your doctor if your side effects are severe, persist or worsen, or if you experience blistering, swelling, warmth, oozing, or fever.
  • If your skin becomes too dry, try rubbing a light moisturizing cream onto the skin an hour before applying a thin layer of Tazorac cream.
  • Tazorac is only for use on your skin. Do not apply to the genital area unless your doctor has told you to do so, and never try to ingest it. If some gel or cream accidentally gets into your eyes, flush these thoroughly with water. Wash your hands after applying Tazorac.
  • Most side effects of Tazorac resolve with continued use as your body adapts to the medication. If these side effects persist, your doctor may instruct you to lower the dose or the frequency of application of Tazorac or to "pulse" treatment with on and off days until you are better able to tolerate it. Always talk to your doctor before changing how much Tazorac you apply.
  • Tazorac can make your skin extremely sensitive to the sun. Always wear sunscreen and wear protective clothing whenever you go outside. Avoid going outside during the hottest part of the day. Getting sunburned may worsen your psoriasis or acne symptoms so try to avoid this. Tell your doctor about any other medications or supplements that you take as these may also exacerbate sun sensitivity.
  • Tell your doctor if you are pregnant or planning to try for a baby before you start Tazorac because Tazorac can harm a developing baby. Your doctor may require you to take a pregnancy test before starting Tazorac. This should come back negative and Tazorac started during your menstrual cycle. Use an effective method of birth control while you are using Tazorac. Tell your doctor immediately if you become inadvertently pregnant.
  • Store at room temperature 68° to 77°F (20° - 25°C) as much as possible; however, occasional lower or higher temperatures are permitted between -5° and 86°F (23° - 30°C).

6. Response and Effectiveness

  • Tazorac starts to have an effect within one to two weeks; however, it may take up to 24 weeks before the full effect is seen.
  • Tazorac cream, 0.05%, and 0.1% were significantly more effective than placebo in reducing the severity of stable plaque psoriasis.
  • Overall clinical success rates were 42% after 12 weeks and 33% after 24 weeks with Tazorac 0.05% cream, and 39% (12 weeks) and 30% (24 weeks) after Tazorac 0.1% cream.
  • Tazorac cream 0.1% was more effective than 0.05% cream; however, it is associated with more side effects including skin irritation.

7. Interactions

Tazorac does not interact with many drugs that are taken orally because it is applied topically to the skin. However, there may be an exacerbating effect with oral medications that also increase sun sensitivity, resulting in severe sunburn. Examples include:

  • aminolevulinic acid (avoid applying Tazorac at least 24 hours before and after taking aminolevulinic acid; some experts recommend a 2-week stand-down period)
  • antibiotics, such as ciprofloxacin, doxycycline, tetracycline, or sulfamethoxazole/trimethoprim
  • thiazide diuretics, such as chlorothiazide and hydrochlorothiazide.

Note that this list is not all-inclusive and includes only common medications that may interact with Tazorac. You should refer to the prescribing information for Tazorac for a complete list of interactions. Tell each of your health care providers about all medicines you use, including prescription and over-the-counter medicines, vitamins, and herbal products.

References

Tazorac Gel (tazarotene) [Package Insert]. Updated 02/2020. Almirall, LLC. https://www.drugs.com/pro/tazorac-gel.html

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Tazorac only for the indication prescribed.

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