Editing Retinoid (section)

==Toxicity==
Toxic effects of retinoids occur with both acute or prolonged intake, depending on which retinoid is considered. The specific toxicity is related to the mechanism of action as well as exposure. A [[medical sign]] of chronic or acute poisoning with [[retinol]] is [[hypervitaminosis A]], which includes the presence of painful tender swellings on the long bones. [[Anorexia (symptom)|Anorexia]], [[Cutaneous condition|skin lesions]], [[hair loss]], [[hepatosplenomegaly]], [[Papilledema|papilloedema]], [[bleeding]], general [[malaise]], [[Idiopathic intracranial hypertension|pseudotumor cerebri]], and [[death]] may also occur.<ref>{{cite book |vauthors=Olson JM, Ameer MA, Goyal A |chapter=Vitamin A Toxicity |date=2024 |title=StatPearls |chapter-url=https://www.ncbi.nlm.nih.gov/books/NBK532916/ |access-date=2024-08-15 |place=Treasure Island (FL) |publisher=StatPearls |pmid=30422511 }}</ref>

Retinoids provoke rapid elevation of circulating [[triglyceride]]s leading to [[hypertriglyceridemia]] as well as cholesterol, leading to [[hypercholesterolemia]].<ref>{{cite journal | vauthors = Esposito M, Amory JK, Kang Y | title = The pathogenic role of retinoid nuclear receptor signaling in cancer and metabolic syndromes | journal = The Journal of Experimental Medicine | volume = 221 | issue = 9 | date = September 2024 | pmid = 39133222 | doi = 10.1084/jem.20240519 | doi-access = free | pmc = 11318670 }}</ref> Retinoids are further shown to worsen many metabolic diseases, such as diabetes and congestive heart failure. Large-scale randomized, controlled clinical trials have conclusively shown that vitamin A, retinol and other retinoids increase mortality and cancer rates.<ref>{{cite journal | vauthors = Goodman GE, Thornquist MD, Balmes J, Cullen MR, Meyskens FL, Omenn GS, Valanis B, Williams JH  | title = The Beta-Carotene and Retinol Efficacy Trial: incidence of lung cancer and cardiovascular disease mortality during 6-year follow-up after stopping beta-carotene and retinol supplements | journal = Journal of the National Cancer Institute | volume = 96 | issue = 23 | pages = 1743–1750 | date = December 2004 | pmid = 15572756 | doi = 10.1093/jnci/djh320 }}</ref><ref>{{cite journal | title = The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers | journal = The New England Journal of Medicine | volume = 330 | issue = 15 | pages = 1029–1035 | date = April 1994 | pmid = 8127329 | doi = 10.1056/NEJM199404143301501 | vauthors = Alpha-Tocopherol BC }}</ref> In addition to the harmful effects shared by other retinoids, [[bexarotene]] causes severe [[hypothyroidism]].<ref>{{cite journal | vauthors = Sherman SI | title = Etiology, diagnosis, and treatment recommendations for central hypothyroidism associated with bexarotene therapy for cutaneous T-cell lymphoma | journal = Clinical Lymphoma | volume = 3 | issue = 4 | pages = 249–252 | date = March 2003 | pmid = 12672276 | doi = 10.3816/CLM.2003.n.006 }}</ref>

The Pharmacovigilance Risk Assessment Committee (PRAC), based on its review, confirmed that taking oral retinoids during pregnancy can have harmful effects on the baby as they may cause CNS, cranio-facial, cardiovascular and other defects.<ref>{{Cite web|title=PRAC recommends updating measures for pregnancy prevention during retinoid use|url=https://www.ema.europa.eu/en/documents/referral/retinoid-article-31-referral-prac-recommends-updating-measures-pregnancy-prevention-during-retinoid_en.pdf|access-date=2023-10-10|publisher=European Medicines Agency}}</ref><ref>{{Cite web |title=PRAC Seeks New Pregnancy Prevention Measures For Retinoids |url=https://www.medscape.com/viewarticle/892514 |access-date=2023-10-10 |work=Medscape }}</ref> The use of acitretin, alitretinoin and isotretinoin should be prohibited in women of childbearing age unless they take measures to prevent pregnancy.<ref>{{Cite web |title=Oral retinoid medicines: revised and simplified pregnancy prevention educational materials for healthcare professionals and women |author=[[Medicines and Healthcare products Regulatory Agency]] |url=https://www.gov.uk/drug-safety-update/oral-retinoid-medicines-revised-and-simplified-pregnancy-prevention-educational-materials-for-healthcare-professionals-and-women |access-date=2023-10-10 |website=GOV.uk }}</ref>

Many lotions that claim to prevent or treat stretch marks contain retinol, which is not an ingredient that is safe for pregnant women.<ref>{{Cite web|title=Skincare Ingredients To Avoid During Pregnancy (+ List Of Harmful Chemicals In Beauty Products)|url=https://www.littlebabygear.com/skincare-ingredients-avoid-pregnancy/|access-date=2023-10-10|work=Little Baby Gear|date=20 December 2022 }}</ref><ref>{{Cite web|title=Is Vitamin A, Retinyl Palmitate and Retinol Safe for Pregnant Women?|url=https://www.metrin.com/blog-is-vitamin-a-retinyl-palmitate-and-retinol-safe-for-pregnant-women/|access-date=2023-10-10|publisher=Metrin Skincare|date=26 May 2022 }}</ref> The Association of the American Academy of Dermatology (AAD) recommends that pregnant women consult a health care provider before trying any lotions or oils for stretch mark prevention.<ref>{{Cite web|title=Pregnancy-Safe Skin Care Guide: Ingredients to Avoid|url=https://www.whattoexpect.com/pregnancy/looking-good/everything-need-know-pregnancy-proof-beauty-routine/|access-date=2023-10-10|work=What To Expect}}</ref>