Retinoic acid and its relationship with fetal malformations
Retinoic acid is a derivative of vitamin A, a fat-soluble vitamin found in many foods. It has beneficial effects on the skin, protecting it from certain diseases. Furthermore, in appropriate doses, it is necessary for proper fetal development.
It is mainly used for the treatment of skin diseases such as acne or psoriasis.
However, it is important to know that:
Administering high doses of vitamin A or its derivatives (retinoic acid, isotretinoin, etehrinate…) systemically (mainly orally) produces harmful effects on the fetus.
Harmful effects of retinoic acid during pregnancy
In fact, it is considered a teratogenic drug (one that causes birth defects). The most significant malformations we are referring to are craniofacial, cardiac, thymic, and central nervous system defects.
These malformations can occur even if pregnancy occurs after discontinuing treatment with these drugs. Therefore, it is recommended to wait between one month and two years (depending on the retinoic acid derivative used) before starting a pregnancy.
What about topical administration?
When these drugs are administered topically , absorption is minimal through healthy skin. It is true that some isolated cases of malformations have appeared that could be attributed to retinoic acid treatment in women who have undergone topical application. However, no teratogenic effects on the fetus have been demonstrated in the various prospective and retrospective studies published.
Malformations may be due to their use on skin lesions or to their administration in conjunction with keratolytic agents (benzoyl peroxide) or in an alcoholic vehicle. Given the known teratogenic effect of these medications when administered orally, and the fact that there have been reported cases of fetal malformations concomitant with their topical use:
It is considered prudent to avoid its use during pregnancy or if attempting to conceive.
What to do if topical use of retinoic acid has already occurred?
Finally, if the patient was unaware of this information and these medications were administered topically during pregnancy, the approach should be reassuring. Differential monitoring compared to other patients is not necessary given the low risk of fetal malformations associated with topical use.
If you found this article interesting and would like to be seen by a specialist in Gynecology and Obstetrics, the Women's Unit at Ruber International Hospital has a specialized unit in this area. You can request more information by calling 917303673, schedule an in-person appointment , or book an online consultation if you prefer; always with top specialists.