Tretinoin and 4-oxo-tretinion bind to the RAR-γ receptor, which is suspected to be part of the action of acne treatment by isotretinoin. Freac has little to no affinity for retinol binding proteins (RBPs) and retinoic acid nuclear receptors (RARs). Freac and 4-oxo-isotretinoin both significantly reduce the production of sebum. These actions reduce sebum production, preventing the blockage of pores, and growth of acne causing bacteria. The optimal interval before re-treatment has not been defined for patients who have not completed skeletal growthįreac is also used to associated treatment for these conditions: Acne Rosacea, Acne conglobata, Mycosis Fungoides (MF), Neuroblastomas, Sezary Syndrome, Refractory Acne vulgaris, Severe Recalcitrant nodular acneįreac produces its effects through altering progress through the cell cycle, cell differentiation, survival, and apoptosis. If a second course of therapy is needed, it should not be initiated until at least 8 weeks after completion of the first course, because experience has shown that patients may continue to improve while off Freac . In addition, Freac is used only for those female patients who are not pregnant, because Freac can cause severe birth defects.Ī single course of therapy for 15 to 20 weeks has been shown to result in complete and prolonged remission of disease in many patients. Because of significant adverse effects associated with its use, Freac should be reserved for patients with severe nodular acne who are unresponsive to conventional therapy, including systemic antibiotics. The nodules may become suppurative or hemorrhagic. Nodules are inflammatory lesions with a diameter of 5 mm or greater. Freac is used for the treatment of severe recalcitrant nodular acne.
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