Psoriasis treatments: Retinoids

Acitretin is an oral retinoid used to treat severe forms of psoriasis, particularly when other treatments have not been effective or are not suitable. It helps regulate the growth and development of skin cells, reducing the excessive growth and abnormal development associated with psoriasis.

How does it work?

Acitretin is a retinoid that affects the growth and development of skin cells. In psoriasis, this can reduce the excessive growth of skin cells and help reduce scaling and thickening of the skin.

Who can get it?

Acitretin should be prescribed by, or under the supervision of, a specialist experienced in the use of systemic retinoids. It is generally used for adults with severe psoriasis when other treatments have not been effective or are unsuitable.

How is it used?

Acitretin capsules are taken once daily with food or milk. The usual starting dose is 25–30 mg daily. The specialist may then adjust the dose according to the response to treatment and any side effects. The usual maintenance dose is 25–50 mg daily.

What are the side effects?

Acitretin commonly causes dryness of the skin and lips, peeling, itching, redness, dry eyes, dry mouth and nosebleeds. Hair thinning or hair loss, muscle or joint aches and increased sensitivity to sunlight can also occur. These effects are often related to the dose and may improve when the dose is reduced.

Acitretin can affect the liver and increase cholesterol and triglyceride levels, so regular blood tests are needed during treatment.

Pregnancy is particularly important. Acitretin can cause serious harm to an unborn baby. It must not be taken during pregnancy. Women who could become pregnant must use effective contraception for at least 1 month before treatment, throughout treatment and for 3 years after stopping acitretin. Regular pregnancy tests are required. Acitretin must not be used while breastfeeding.

Patients must not donate blood during treatment or for 3 years after stopping acitretin.

Alcohol should be avoided during treatment and for 2 months after stopping treatment. Vitamin A supplements and other retinoid medicines should not be taken unless specifically advised by a doctor.

Acitretin can increase sensitivity to sunlight, so excessive exposure should be avoided and appropriate sun protection used.

Marketed by

Acitretin is available on prescription only and is known commercially as Neotigason. It is marketed in the UK by Genus Pharmaceuticals.

Reviewed: August 2026

Version ID: 2/ACI/PST/08/26

This page is for reference only as this product is now discontinued

Tazarotene is a retinoid used for the topical treatment of plaque psoriasis. It binds to nuclear retinoic acid receptors inducing normal differentiation of keratinocytes and reducing hyperkeratosis. It also reduces the formation of cytokines and interleukins that are responsible for inflammation. Because tazarotene is applied to the skin, systemic exposure is generally low. However, irritation at the site of application is relatively common. It belongs to the group of medicines known as topical retinoids.

How does it work?

Tazarotene is a topical retinoid. It is applied directly to psoriasis plaques and helps regulate the growth and differentiation of skin cells and reduce inflammation. The clear, fast-drying, odourless, non-staining medication is available in two strengths, 0.05% and 0.1%. Your doctor will prescribe the appropriate strength for you, given such factors as your medical history, skin type and degree of psoriasis.

How is it used?

Tazarotene can be applied to most parts of the body, but should not be applied to intertriginous areas or to the face or to hair covered scalp. It should be applied once per day and usually about 30 minutes before bedtime. This allows the medication to dry sufficiently so it will not rub off on bedding, where it may come in contact with other skin during the night. Although it is not harmful to unaffected skin, Tazarotene can cause burning and itching. To prevent irritation, keep Tazarotene on the psoriasis plaques and avoid contact with unaffected skin.
Tazarotene should not be applied "liberally." In fact, a pea-sized amount of the gel is enough to cover a lesion the size of the open palm. Rub the medication thoroughly into the lesion, leaving no residue. If the gel does come in contact with normal skin, it can be washed off with water.

Using Tazarotene on the nails

Tazarotene is not routinely used for nail psoriasis. Your dermatologist can advise on appropriate treatments for nail involvement.

What are the side effects?

The main adverse effects are indeed local irritation, including:

• itching
• burning
• redness
• irritation
• peeling/scaling
• dry skin
• stinging

The most frequently reported adverse reactions in controlled clinical trials of Tazarotene in the treatment of psoriasis were pruritus (incidence 20-25%), burning, erythema, and irritation (10-20%), desquamation, non-specific rash, irritant contact dermatitis, skin pain, and a worsening of psoriasis (5-10 %).
More rarely observed were stinging and inflamed and dry skin (1-3 %).
The incidence of adverse reactions appears to be concentration-related and dependent on duration of use. Skin irritation may be more noticeable when treatment is started and can be more pronounced with higher-strength preparations.

Tazarotene must not be used during pregnancy or by women who are planning to become pregnant. If you are pregnant, think you may be pregnant or are planning a pregnancy, speak to your doctor. If you are breastfeeding, ask your doctor for advice before using tazarotene.

How do I get

Tazarotene is available on prescription. Treatment should be prescribed and monitored by a healthcare professional experienced in treating psoriasis.

Marketed by

Tazarotene is known commercially as Zorac and is marketed in the UK by Allergan Ltd.

Reviewed: August 2026

Version ID: 2/TAZ/PST/08/26