Trifera

• Approved Indications:
• Treatment of acne vulgaris, including both facial and truncal acne.
• Suitable for patients aged 9 years and older with mild to moderate acne characterized by comedones, papules, and pustules.
• Off-label Uses:
• Occasionally used off-label in certain keratinization disorders, though not officially approved.

• Adults and Pediatric Patients (≥9 years):
• Apply a thin layer of trifarotene cream or gel once daily to the affected areas of clean, dry skin, typically in the evening.
• Use a pea-sized amount for each treatment area to avoid excessive irritation.
• Treatment duration generally ranges from 12 weeks or longer based on clinical response.
• Elderly:
• Use as in adults with caution, considering potential increased skin sensitivity.
• Special Populations:
• No dosage adjustments required for patients with renal or hepatic impairment due to minimal systemic absorption.
• Administration Route:
• Topical application only. Avoid contact with eyes, lips, and mucous membranes.

Trifarotene is a selective retinoic acid receptor gamma (RAR-γ) agonist. By binding specifically to RAR-γ, the predominant retinoic acid receptor in the epidermis, it modulates gene expression that regulates keratinocyte differentiation and proliferation. This action normalizes the process of skin cell turnover, reducing follicular hyperkeratinization and preventing the formation of new comedones. Additionally, trifarotene exhibits anti-inflammatory effects, which help decrease acne lesion formation and promote skin healing.

• Absorption: Minimal systemic absorption following topical application.
• Distribution: Limited systemic exposure; local effect primarily in the epidermis.
• Metabolism: Metabolized by skin enzymes into inactive metabolites.
• Elimination: Metabolites are excreted primarily via the kidneys.
• Half-life: Systemic half-life is negligible due to low absorption.
• Onset of Action: Improvement in acne lesions typically observed after 4 to 12 weeks of continuous treatment.

• Pregnancy:
• Use during pregnancy is not recommended due to the known teratogenic effects of retinoids. There is no adequate data on trifarotene’s safety in pregnant women.
• Lactation:
• It is unknown if trifarotene is excreted in human milk. Caution is advised when used during breastfeeding; avoid applying on large body areas.

• Primary Therapeutic Class: Topical retinoid
• Subclass: Selective RAR-γ agonist, fourth-generation retinoid

• Hypersensitivity to trifarotene or any component of the formulation.
• Pregnancy or suspected pregnancy.
• Application on broken, eczematous, or damaged skin.
• Use on mucous membranes, eyes, or lips.

• Increased susceptibility to sunburn; patients should avoid excessive sun exposure and use sunscreen.
• Skin irritation, including redness, peeling, dryness, and burning sensation, may occur, especially during initial weeks.
• Avoid concurrent use of other potentially irritating skin products.
• Discontinue if severe irritation or allergic reaction develops.
• Use with caution in patients with photosensitivity disorders.
• Safety and efficacy have not been established in children under 9 years.

• Common Side Effects:
• Localized erythema (redness)
• Dryness and scaling
• Itching and burning sensation
• Mild stinging at the application site
• Serious Side Effects (Rare):
• Severe dermatitis or allergic contact dermatitis
• Photosensitivity reactions requiring medical intervention

• No known significant systemic drug interactions due to minimal systemic absorption.
• Avoid concomitant use with other topical retinoids or products that increase skin irritation.
• Avoid combining with photosensitizing agents.

• Recognized as the first topical retinoid approved for truncal acne in addition to facial acne.
• Recent dermatological guidelines recommend trifarotene as a first-line topical agent for mild to moderate acne involving face and trunk.
• Emphasis on its selective RAR-γ targeting for improved efficacy and tolerability.

• Store at 20°C to 25°C (68°F to 77°F) in a tightly closed container.
• Protect from excessive heat, moisture, and light.
• Do not freeze.
• Keep out of reach of children.