What is Acitretin?Acitretin is used in the treatment of psoriasis and other diseases.
Acitretin is a derivative of retinol, vitamin A. In addition to a variety of physical functions, vitamin A plays an important role in ensuring the health of the skin and mucous membranes.
Thus retinol ensures the normal cell division in the skin and also prevents DNA damage in the skin cells. Due to its chemical relationship with retinol, acitretin has the same effect on skin growth and is therefore used in skin diseases, especially psoriasis as a medicine.
It is administered by the use of capsules containing acitrite, whereby the released active substance has a regulating influence on certain abnormal processes in the skin. Although not able to cure skin diseases, Acitretin can combat the symptoms of unusual cell division activities.
As already explained, acitretin regulates the cell division rate of skin cells. So psoriasis is a skin disease that is based on a dysregulation of new cell formation in the skin.
The causes of psoriasis are manifold. In addition to genetic factors, autoimmune reactions and drug influences also play a role. It is a systemic disease that ultimately manifests as a disordered and accelerated rate of cell division of the skin cells. The healthy skin is renewed within 28 days by cell division. The cells forming the horny layer (keratinocytes) pass through the skin to the surface and become horny cells. When washing or rubbing the dead horny cells are well removed.
In psoriasis, keratocytes sharply divide, while transformation into horny cells shortens to 3-5 days. Both processes cause an intense dandruff. Acitretin regulates the uncontrolled proliferation of skin cells while ensuring the slow maturation of new cells.
Furthermore, acitretin has a direct detaching effect on the cornea. This effect is noticeable after just a few days of treatment. However, the underlying mechanism is not clear. After discontinuation of the drug, the process starts again. Although the symptoms are alleviated, the disease process itself is not changed.
Medical application & use
The main area of application of Acitretin is the treatment of severe forms of psoriasis when other treatments no longer work. The drug is administered orally in the form of capsules.
The active ingredient has a bioavailability of about 60 percent and is 99 percent bound to plasma proteins in the blood. The half-life of acitretin in the body is approximately 49 hours. The most effective dose is above 10 mg per day. Depending on the body weight, there is an optimum effect of about 50 mg per day. It should be noted that the effect occurs at the earliest after 4-6 weeks.
After 2-3 months, the symptoms disappear completely in 80% of cases. The cause of the disease, however, persists, so it is a purely symptomatic treatment. Other indications are indicated in severe, but sometimes rare, skin diseases.
These include diseases with severe eczema, genetic skin diseases and certain types of cancer, such as basal cell carcinoma or cutaneous T-cell lymphoma. These diseases can only be treated symptomatically with acitretin.
Risks & Side Effects
As with most medications, side effects may also occur with the use of acitretin. The use of this drug during pregnancy and lactation is absolutely contraindicated because acitretin has a high degree of teratogenic (teratogenic) effects.
Since overdoses, such as vitamin A, can also cause symptoms of intoxication, the use of acitretin in liver diseases, lipid metabolism disorders, diabetes, renal insufficiency and of course hypersensitivity to the drug should be avoided.
In particular, the combined use with tetracyclines (broad-spectrum antibiotics) or methotrexate (immunosuppressive cytostatic drug) is contraindicated. Even when authorized use can cause undesirable effects such as dry mouth, rhinitis, nosebleeds, skin dryness, blurred vision and increased cholesterol and liver values. Long-term therapy can lead to ossification. In addition, increases in Acitretineinsatz the sun sensitivity of the skin.