Is Wrinkled Skin Normal After 8 Days of Oral A Acid for Psoriasis?

Is it normal for the skin on the fingers to wrinkle when a psoriasis patient takes oral acitretin?

Hello, I was recently diagnosed with psoriasis by a dermatologist, and the doctor prescribed me oral retinoids.
Today is the 8th day of my medication, and I've noticed that the skin on my fingers is cracking and becoming wrinkled (as shown in the image).
Is this a normal occurrence? How can I improve this condition? Thank you!

Leina, 30~39 year old female. Ask Date: 2023/07/03

Dr. Wu Yuxin reply Dermatology

Any changes in the lesions after medication, or unexpected changes in other parts of the body, should be discussed face-to-face with the prescribing physician, as online consultations cannot provide diagnoses or treatment decisions.

Reply Date: 2023/07/03

More Info

When it comes to the use of oral A acid (also known as isotretinoin) for treating psoriasis, experiencing wrinkled skin after just eight days of treatment can be concerning. Isotretinoin is a powerful medication primarily used for severe acne but is also prescribed for other skin conditions, including psoriasis. It works by reducing the size and activity of sebaceous glands, leading to decreased oil production and promoting skin cell turnover.
In the early stages of treatment, it is not uncommon for patients to experience various skin changes, including dryness, peeling, and even a wrinkled appearance. This is due to the medication's effect on the skin's oil production and its ability to accelerate the shedding of dead skin cells. While some degree of dryness and peeling is expected, significant wrinkling or cracking of the skin, especially on areas like the fingers, may indicate that the skin is becoming overly dry or irritated.

To address these concerns, here are some recommendations:
1. Moisturization: It is crucial to keep the skin well-hydrated while on isotretinoin. Use a thick, emollient moisturizer that is suitable for sensitive skin. Look for products that contain ingredients like hyaluronic acid, glycerin, or ceramides, which can help retain moisture and repair the skin barrier.

2. Gentle Cleansing: Use a mild, non-irritating cleanser to avoid further stripping the skin of its natural oils. Avoid harsh scrubs or exfoliants, as these can exacerbate dryness and irritation.

3. Avoid Irritants: Be cautious with other topical treatments or products that may irritate the skin. This includes products containing alcohol, fragrances, or strong active ingredients that could lead to further dryness or irritation.

4. Sun Protection: Isotretinoin can make the skin more sensitive to sunlight, increasing the risk of sunburn. Use a broad-spectrum sunscreen with an SPF of 30 or higher, and reapply it regularly, especially if you are outdoors.

5. Consult Your Dermatologist: If the wrinkling and dryness persist or worsen, it is essential to consult your dermatologist. They may adjust your dosage or recommend additional treatments to help manage the side effects. They can also provide personalized advice based on your specific skin condition and treatment plan.

6. Hydration: Ensure you are drinking plenty of water to help keep your skin hydrated from the inside out.

In summary, while some degree of skin wrinkling and dryness can be a normal reaction to isotretinoin, it is essential to manage these symptoms proactively. If you find that your skin condition is not improving or is causing significant discomfort, do not hesitate to reach out to your healthcare provider for further guidance. They can help ensure that your treatment for psoriasis is both effective and tolerable.

Similar Q&A

Understanding Psoriasis and Seborrheic Dermatitis: Key Insights and Concerns

Hello Dr. Chang, I apologize for bothering you, but my skin condition has been quite poor, and I have another skin issue I would like to consult about: 1. I have seborrheic dermatitis on my face, especially around the nostrils, which tends to peel and even exude serous fluid du...

Dr. Zhang Zhibo reply Dermatology
Hello, Student Zhang: 1. Regarding the facial symptoms you mentioned, it is indeed seborrheic dermatitis; however, the presence of exudate is not characteristic of seborrheic dermatitis. It may be associated with a bacterial infection of the epidermis due to scratching from itch...

Does Oral A Acid Cause Cysts? Understanding Skin Reactions

Hello, doctor. When the physician prescribed me oral isotretinoin, they mentioned that I might experience breakouts in one to two weeks. Is it possible for cysts to appear as a result of taking oral isotretinoin? Thank you.

Dr. Wu Yuxin reply Dermatology
Usually not.

Post-CO2 Laser Skin Care: Essential Tips for Healing and Maintenance

Hello Doctor: I underwent full facial laser scar removal surgery last week. The scabs on my face have completely fallen off, but my face still appears somewhat red, and there are some areas that feel itchy. The doctor who performed the laser treatment advised me to focus on moist...

Dr. Lin Xinpeng reply Dermatology
Hello: 1) If the scab has fallen off, it indicates that the epidermal layer has healed. In principle, basic skincare products can be used, but attention should be paid to the ingredients. If they contain whitening toners or lotions, their use should be delayed. For sunscreen, it ...

Recommended Intervals for Laser Treatments and Acids in Dermatology

Hello Dr. Wu, I recently had fractional laser treatment on my face, and the staff at the clinic informed me of the following: 1. It is recommended to wait two weeks after fractional laser treatment before undergoing hyaluronic acid injections? 2. Can I receive fractional laser tr...

Dr. Wu Yuxin reply Dermatology
Questions 1 and 2 are indeed correct; a gap of 1-2 weeks, or even longer, is necessary. If you are undergoing higher energy treatments, adjustments may need to be made based on recovery status and the skin's tolerance to stimulation. For Question 3, general alpha hydroxy aci...