Tazorac
What is Tazorac and how does it work?
Tazorac topical gel and cream (also known by its generic name tazarotene) are FDA-approved for treating plaque psoriasis. Tazorac is a vitamin A derivative and is also known as a topical retinoid.
Tazorac gel is a water-based emollient that slows the rapid growth of skin cells found in psoriasis. The clear, fast-drying, odorless, non-staining medication is available in two strengths, 0.05% and 0.1%. Your doctor will prescribe the appropriate strength for you, given such factors as your medical history, skin type and degree of psoriasis. Tazorac cream also is available in strengths of 0.05% and 0.1%. The cream contains a moisturizer, which may make it more tolerable than the gel for people with drier skin, people in harsh climates and people with sensitive skin.
How well does Tazorac work?
Tazorac can induce long-term, treatment-free remissions for some patients. Some patients experience remissions of up to 12 weeks or longer after stopping the medication. Patients may see improvement in two weeks, but it may take eight to 12 weeks to see optimal clearing and improvement when using Tazorac. Do not give up if the results are not immediate; persistent use of Tazorac is important for achieving treatment success.
How is Tazorac used?
Tazorac can be applied to most parts of the body, including the face, hairline and scalp. It should be applied once per day, and usually about 30 minutes before bedtime. This allows the medication to dry sufficiently so it will not rub off on bedding, where it may come in contact with other skin during the night. Although it is not harmful to unaffected skin, Tazorac can cause burning and itching. To prevent irritation, keep Tazorac on the psoriasis plaques and avoid contact with unaffected skin.
Tazorac should not be applied "liberally." In fact, a pea-sized amount of the gel is enough to cover a lesion the size of an open palm. Rub the medication thoroughly into the lesion, leaving no residue. If it comes in contact with unaffected skin, it can be washed off with water.
Do not cover (occlude) Tazorac-treated skin with dressings or bandages of any kind unless recommended by a doctor. Tazorac gel should be used on only up to 20 percent of the body's surface at any time, while the cream can be applied on up to 35 percent of the body at any one time. Always wash your hands after applying Tazorac, unless the hands are being treated.
Tazorac is not recommended for use in the genital area or around the eyes.
Both Tazorac gel and cream can dry the skin, so use a moisturizer for best results. Allow the moisturizer to totally absorb and dry before Tazorac is applied. This usually takes at least 30 minutes. If the moisturizer is not dry, Tazorac may come in contact with the unaffected skin.
Using Tazorac on the scalp
Tazorac can be used on the scalp and around the hairline. Apply it to a dry scalp and allow it to dry completely before going to bed. This helps prevent Tazorac from rubbing off on your pillow and spreading to your face or other body areas. Similar to Dovonex, sweating can transfer the medication to unaffected skin on the neck and face.
Using Tazorac on the nails
Some patients have successfully treated nail psoriasis with Tazorac. Carefully follow usage directions to avoid irritation.
Side effects of using Tazorac
No effects on the internal organs were seen in the clinical studies required by the FDA for approval of Tazorac gel and cream. The most common problem was skin irritation, which occurred in up to 40 percent of patients during the medical studies.
To test for the possibility of skin irritation, apply Tazorac on a small, stubborn lesion for several days before applying the medication to lesions on other areas of the body. If irritation occurs, apply a moisturizer to the affected areas before applying a thin layer of Tazorac, or reduce the frequency of application.
Tazorac may make your skin more susceptible to sunburn. Use a sunscreen (minimum SPF 15) and wear protective clothing if you expect to be exposed to the sun while you are using Tazorac. As with any medication, consult your doctor if you experience any unusual discomfort.
Tazorac is not recommended for use by pregnant women, women attempting to become pregnant or women who are breast-feeding. Women in their childbearing years should use reliable birth-control measures during treatment with Tazorac. Tazorac can be absorbed and cause serious birth defects. Tazorac has no effect on sperm, so it is safe for a woman to become pregnant while her partner is using the medication.
The safety and effectiveness of Tazorac have not been established for children under the age of 12.
It is normal for psoriasis plaques to become very red before clearing when using Tazorac. The redness is often intense in color, but it is generally not painful. On the other hand, if you have symptoms of irritation–discomfort, burning, itching or stinging–check with your doctor.
Using Tazorac with other treatments
Compared to using Tazorac alone, the combination treatment with a mid- to high-potency topical steroid can lead to faster clearing of plaques, as well as reduced irritation, redness and itching. When combining Tazorac with a steroid, apply the Tazorac at night before bed and use the steroid in the morning. The reverse regimen can also work, as long as the two medications are applied at opposite ends of the day. Some doctors may also recommend using Tazorac and a steroid on alternating days.
Combining Tazorac with phototherapy treatment has proven more effective for clearing psoriasis than either treatment alone.
Updated June 2006
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