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Can tretinoin cream be bought over the counter in Australia? A: Yes – it is a prescription-only medication as treatment for moderate to severe acne [4]. In general terms, this means that it should only be Strattera 18mg $130.17 - $1.08 Per pill used by patients whose physician has prescribed the medication for that purpose, so long as they have been referred by a dermatologist. Most experts recommend against it being available over the counter without a prescription in Australia, because it has not been cleared for sale as it is. Some patients are still unaware of this and may take as a reason to avoid it, or even turn to buying it on the black market. In some countries, where the medication is only available to prescription buyers, the black market is more prevalent. [5] How has tretinoin treated my acne? Tretinoin is effective for mild to moderate acne, such as spot, cystic, and nodular acne. It is not likely to be effective for severe acne, especially if it has an inflamed scar. As well, tretinoin is not a cure-all for acne. It can reduce acne symptoms such as peeling and dryness, however, it is likely that will not resolve the cause of acne or stop the inflammatory process. How does tretinoin work to treat acne? Acne is caused by the body's own immune system fighting infections. In this situation, the body produces certain chemicals, called immunomodulators, which can temporarily make the skin more susceptible to becoming infected. When this happens, the immune system will attempt to kill the infection, which may be a virus or bacteria (including P. acnes ). This can be a good thing, but in some cases, the immune response can become excessive [6]. If this happens, the body will start looking for its own way of removing the invader so that it can stop from spreading. This involves the production of inflammatory proteins called cytokines. Acne is most common in the evening when skin is most vulnerable [7]. If you have a skin disease such as acne, you may not have a noticeable skin flare-up during the day [8]. One of the main active ingredients in tretinoin is known as A, an enzyme that breaks down the cells and blocks production of inflammatory cytokines. It acts by suppressing the immune response, so reducing inflammation from p. acnes bacteria. When applied topically, the tretinoin A can reach to deep within pores, so tretinoin is generally not applied in larger areas than the actual acne area or to certain areas, such as the eyelids, this may irritate skin [9]. The tretinoin also acts as a UV blocker, preventing the sun's damaging rays from skin. Tretinoin is thought to work as a synergist with benzoyl peroxide, topical acne treatment often used alongside it. In theory, this would mean that tretinoin works with over-the-counter acne treatments to reduce inflammation and speed the progress or cure of acne. As we will see below, this does not always work [10] Tretinoin is one of the first drugs to be used treat hyper-pigmentation or melasma. As we saw in our previous article, melasma occurs when excess pigment in the skin is blocked from reaching the hair and eyes. Tretinoin and the risk of hyperpigmentation Although tretinoin has been shown to reduce hyper-pigmentation in some patients, others say that the drug can increase risk of hyper-pigmentation by causing the skin to break out in small, inconspicuous patches [11]. A few people who use tretinoin are known to develop melanoma, a cancer of the skin. While this is rare, as noted in their review article, this risk applies only to people who are predisposed developing melanoma as patients who use tretinoin are more likely to develop acne or rosacea in the first place. [12,13] Other than that, there are no proven links between the use of tretinoin and development melanoma. Should I avoid tretinoin? If you are not sure whether to avoid it, then I will suggest that you do. As it has been shown that there are certain patients who have a tendency to develop hyper-pigmentation – especially people who already have mild acne – you should probably avoid tretinoin as much you possibly can. However, if use it for more than six months, you are much more likely to develop melasma, which is not likely to be treated with tretinoin. People with hyper-pigmentation should check canada pharmacy 24h discount code their dermatologist before using tretinoin and if they notice any change in their acne or hyper.