Retin-A safe to use for psf sufferes?

@hopeless94 any update??

I use tretinoin 0.1% and it does not affect me in any negative way.

Still not sure. Iam using 0.1% adapalene at the moment. I have moderate to severe acne and obviously I dont wanna hop on isotretinoin as someone who developed PFS.

I did the research and the systemic absorption from topical retinoids seems neglible. But there are people who reported harm from topical agents. Therefore I will be switching to trifarotene, which has binds only to those retinoid receptors in the skin, whereas most other retinoids also bind to RAR-beta which is also present in the prostate. I dont know how relevant that is, but I want to make sure.

Stop putting value in how you look. Stop seeking medication to look “better”. Remember, that’s what got you on this forum in the first place.

For acne, avoid dairy, avoid stress (Wim Hof breathing and meditation are good for this), and do cold showers a few times a week. This will improve your acne in the long term. Tretinoin only improves it in the short term.

No extremely rare and not official reported side effects put me here.

Tretinoin works as long as you use it.

I tried retinol for 6 months since i have rly bad issue with facial skin( sleeping wrinkles all over whole face…) it worsened my skin massivily. My second biggest mistake. Id not fuck with it

There is a member of one of the post-Accutane groups on facebook who says she got “PAS” after using Retin-A or some other generic topical tretinoin product.

It’s worth considering that 38% of tretinoin was converted into isotretinoin (Accutane) by UV light in a study using cadaver skin and this percentage may be much higher in live skin due to active isomerase enzyme activity.

Lehman, Paul A., and Andrew M. Malany. “Evidence for Percutaneous Absorption of Isotretinoin from the Photo-Isomerization of Topical Tretinoin.” Journal of Investigative Dermatology , vol. 93, no. 5, Nov. 1989, pp. 595–99. ScienceDirect , https://doi.org/10.1111/1523-1747.ep12319721.

…A link to full text doesn’t appear to be available.

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I was using 0.1% adapalen since late december and it cleared pretty much my acne. There are not many medical interventions for acne, either its retinoids or anti-androgen substances like azelaic acid. To my mind only topical antibiotic and BPO are seem to be completly safe and have decent efficacy.

Although I didnt notice any changed in sexual functions and I think there might be an influence. So I have stopped for over one week and now Iam using it again to see if it causing any problems.

Nonetheless I will probaly stop regardless of it.

The thing is, retinoids ARE anti-androgenic at the doses/concentrations used therapeutically for skin conditions.

This is true of isotretinoin, tretinoin, alitretinoin, and the carotenoid, astaxanthin.

Simply being an agonist of retinoic acid receptors exerts an anti-androgenic effect via upregulation of FOXO1.

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Yeah but to what extend? Systemic absorption seems very low, unlikely that topical retinoids result in hormonal changes that are even detectable. This is just another PFS mystery that we are hypersensitive to anti-androgens.

my last hope is trifarotene. its an retinoid that was designed to have a low systemic effect. It only binds onto one specific retinoid receptor.

Thank you for bringing attention to this. I’ve been using azelaic acid for a month and have already noticed worsening of my condition. I was unaware of possible connection. I’m also searching for a good anti-acne treatment that won’t make my condition even worse.

Azelaic acid is highly anti-androgenic.

Combination of clindamycin and benzolperoxide seems to be the most effective treatment while having no anti-androgenic effect. You can also try AHA-Peelings.

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Thanks a lot. Have you already tried trifarotene? I haven’t heard about it before but now I have some hopes too.

Nope in theory it has the highest chance of not getting into the system.

Little Update btw: Applied Adapalen yesterday evening and actually feeling better. Not so much sexual that was fine before but more mental. Better mood and emotion. I also feeling my body more. So yes it seems to be interfering with it. not unsual that anti androgens male bwtter in the short term.

Iam not quite confident about the causation because it was only one application. I dont know how I can even test if it has a bad effect on me. I mean maybe the effects take several days of usage or weeks to show up. I started in December 2021 and didnt notice much maybe more mental side effects.

Thats the reason why I didnt give a fuck about thinking of every food and substance that could possibly have anti androgenic effects. Its too much and made me neurotic.

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Really, all that can be said is that it’s to the extent that there are a few people floating around on Accutane-related social media claiming persistent sides from topical retinoids. The same as topical finasteride and minoxidil, and topical anti-androgens for acne like Breezula/Winlevi, were supposed to not have systemic effects, but landed people on this forum regardless.

Also some varying responses to topical retinoids reported on this site, of which, you are already aware of a couple:
Adapalene story
Retin-A inhibits DHT?
Topical retinoids for acne as a pfs patient

Only point I’m trying to make is that I hope you’re not another one to solve the mystery of how much of an effect is too much.

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Yes. I dont wanna play with fire.

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stay away from azelaic acid,

Not that there aren’t members here who have had bad reactions from foods, but the amounts of natural substances like astaxanthin, when sold as supplements, are often hundreds to thousands times the amount you would ingest from large portions food sources.

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I dont know. Maybe the reason why carnivore or ketogenic diet worked for some people is that you just eleminate endocrine disruptors in foods.

My problem is that in theory the amount of hormonal active substances found in food is absolutely negligble. Same goes for topical agents. I found one case in which topical retinoids caused side effects. one woman who had a damaged skin barrier and some existing disease. There is absolutely no data of topical agents concerning side effects which are even near to oral isotretinoin.

This anti-androgenic sensibility as part of pfs makes no sense in theory. But same goes for pfs in general. Iam one of the few people who knew about PFS/PAS but took it nonetheless.

Watched the huberman podcast recently in which he talked about light and skin. Turns out there is a study which shows increase of testosteron and estrogen when exposed to UV-B rays. He said that the skin is actually an organ which has important endocrine functions. Therefore I assume that topical usage of drugs like Azelain acid or retinoids dont influence hormonal levels due to systemic absorption if that particular drug but rather by altering hormonal production of the skin cells itself.

This is just a theory. But it could explain why topical usage of anti androgens might cause side effects despite lack of systemtic absorption

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