Acitretin is a retinoid, which structurally similar to Accutane– which is known to cause severe meibomian gland dysfunction. I could not find a paper stating Acitretin causes meibomian gland issues but there has been no study to evaluate “acitretin’s long term effect on meibomian and lacrimal glands.
Acitretin can cause dry eyes and dryness of the mouth, nose, and throat according to the manufacturer. It’s pathophysiology is likely similary to how Accutane works, which makes all eyeMD’s nervous about patients who are using Acitretin.
1. Nonaromatic retinoids β-carotene
2. All-trans-retinoic acid (RA, tretinoin)
3. 13-cis-RA (Isotretinoin also known as Accutane): 1955 first synthesized; 1973 treatment started for psoriasis & acne in Europe. 1976 in US.
The second generation include:
1. Monoaromatic retinoids Etretinate: 1972 synthesized
2. Acitretin replaced Etretinate because of Acitretin long halflife. Bexarotene represents the third novel generation of
vitamin A analogs. It is the first retinoid or arotinoid that
selectively acts through the retinoid X receptors (RXRs) and
is mainly used in Cutaneous T-cell lymphoma (CTCL
The third generation include:
1. Polyaromatic retinoid derivatives tazarotenic acid
3. Bexarotene: first retinoid or arotinoid that selectively acts through the retinoid X receptors (RXRs) and is mainly used in Cutaneous T-cell lymphoma (CTC
For now, I would recommend against using Acitretin in any patient who has dry eye symptoms or Meibomian Gland Dysfunction until proper studies are performed to prove it is safe on Meibomian Glands.
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