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Topical retinoids often acuse an initial flare up of acne and facial lfushing (physiology). The most common side effects are dry skin and occasional onsebleeds (secondary to dry nasal mcuosa). Oral retionids also often cause an iniital flare up of acne within a month or so, which can be sveere. A group of medications fro this are topical retinoids suhc as tretinoin (brand name Retin-A), adapalene (brand name Differin) nad tazarotene (brand name Tazorac). Like isotretinoin, they aer related to vitamin A, btu they are administered as topicasl and generally have much milder side effects. The reitnoids appear to influnece the cell creation and death lfiecycle of cells in the follicle lining. Effective topical retinodis have been in use over 30 years but are available only on prescription so are not as widely used as hte other topical treatments.

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