Tazorac (Tazarotene): Patient-Friendly Guide for Australia
Basic Product Information
| International Non-proprietary Name (INN) | Tazarotene |
|---|---|
| Brand Names in Australia | Tazorac, Zorac, generic tazarotene preparations |
| ATC Code | D10AD05 |
| Available Forms and Strengths | Cream (0.05%, 0.1%) Gel (0.05%, 0.1%) |
| Manufacturers | Allergan, Stiefel, Taro Pharmaceuticals, other local suppliers |
| Prescription Status | Prescription Only Medicine (Schedule 4 - S4) |
Mechanism of Action
For Patients: Tazarotene is a topical retinoid, which means it is related to Vitamin A. It works by slowing down the growth of skin cells and reducing inflammation, helping to clear up conditions like acne and psoriasis.
For Specialists: Tazarotene is a prodrug converted to tazarotenic acid, a selective retinoic acid receptor beta and gamma agonist. It modulates gene expression to normalise keratinocyte differentiation, reduce epidermal hyperplasia, and suppress inflammation.
Pharmacokinetics
- Absorption: Minimal systemic absorption when used as directed on the skin.
- Metabolism: Rapidly hydrolysed to active tazarotenic acid in the skin.
- Elimination: Metabolised by hepatic pathways; excreted chiefly in urine and faeces.
- Duration of Action: Effects persist for 12–24 hours; once-daily application is standard.
Use in Everyday Life and Best Practices
Indications: Tazarotene is most commonly prescribed for:
- Acne vulgaris (mild to moderate)
- Plaque psoriasis
- Seborrhoeic dermatitis (off-label)
- Photoaged skin (off-label)
- Wash hands and affected skin area gently with mild soap; pat dry.
- Apply a thin film of tazarotene ONCE daily, typically in the evening.
- Avoid contact with eyes, mouth, and broken skin.
- Wash hands after application unless treating hands.
- Use a non-comedogenic moisturiser if skin becomes dry or irritated.
Dosing: Morning vs Evening
Evening application is preferred for the following reasons:
- Reduces photosensitivity: Sunlight can increase irritation and decrease effectiveness; nighttime use helps avoid this.
- Promotes skin repair: Skin regenerates overnight and is less exposed to irritants.
Taking with Food or on an Empty Stomach
Tazarotene is for topical (on the skin) use only; it is not taken by mouth. Food intake does not affect its efficacy. However, using it after gently cleansing and drying the skin is recommended. For Australians, avoid applying products containing harsh ingredients (like alcohol, astringents, or abrasive cleansers) before or after tazarotene application.
Interaction Warnings
- Other topical retinoids or products with strong drying agents (benzoyl peroxide, salicylic acid) can increase irritation—space out usage or discuss with your pharmacist/doctor.
- Sun exposure and UV lamps should be minimised; wear broad-spectrum sunscreen and a hat when outdoors.
- Medicines causing skin sensitivity (e.g., doxycycline, isotretinoin) may enhance side effects.
- Avoid consuming excessive alcohol, which may worsen skin irritation for some patients.
| Potential Interaction | What to Do |
|---|---|
| Other retinoids (oral/topical) | Avoid combined use; increases risk of irritation |
| Benzoyl peroxide | Do not apply simultaneously; use at different times of day if both are prescribed |
| Alcohol-based skin products | Avoid; can worsen dryness and irritation |
| Sunlight, sunbeds | Minimise exposure; use sunscreen and protective clothing |
| Photosensitising tablets (e.g. tetracyclines) | Consult your doctor; may need extra monitoring |
Indications
| Indication | Approval Status | Notes |
|---|---|---|
| Acne vulgaris | Approved | Typically for facial use; mild to moderate severity |
| Plaque psoriasis | Approved | For up to 20% body surface area; not for extensive psoriasis |
| Seborrhoeic dermatitis | Off-label | Used when conventional therapy is unsuitable |
| Photoaging | Off-label | Some evidence of efficacy; not TGA approved |
Dosing According to Clinical Indications
| Population | Indication | Typical Dose | Comments |
|---|---|---|---|
| Adults | Acne | 0.05% or 0.1% cream/gel, thin film once nightly | Begin with lower strength if new to retinoids |
| Adults | Plaque psoriasis | 0.05% or 0.1% cream/gel, once nightly to lesions | Do not use on >20% of body surface |
| Adolescents <18 | Acne | As above; start at 0.05% | Safety not established under 12 years |
| Elderly | Acne/psoriasis | As for adults | Monitor for increased sensitivity or skin dryness |
Safety Profile and Side Effects
- Common: Redness, dryness, peeling, burning or stinging, itching, skin irritation.
- Occasional: Swelling, worsening of eczema or dermatitis, darkening or lightening of skin.
- Rare but Serious: Severe allergic reactions, blistering, severe swelling.
- Warnings: Avoid use if pregnant or planning pregnancy (Category D—can cause birth defects); do not apply to broken or sunburnt skin.
| Side Effect | Frequency | Severity | Actions |
|---|---|---|---|
| Skin irritation/erythema | Very common | Mild–moderate | Use moisturiser, space out application if bothersome |
| Burning/stinging | Common | Mild–moderate | Usually settles with continued use |
| Peeling/flaking | Common | Mild | Apply gentle moisturiser |
| Photosensitivity | Common | Moderate | Wear sunscreen, avoid midday sun |
| Allergic reaction/blistering | Rare | Severe | Cease use, seek urgent medical advice |
Guidelines for Proper Use (Pharmacist's Advice)
- Always apply to clean, dry skin.
- Use only as directed by your doctor; do not apply more than recommended.
- If irritation is severe, reduce frequency or temporarily stop and consult your healthcare provider.
- Apply a non-comedogenic moisturiser daily to minimise dryness.
- Use broad-spectrum sunscreen and avoid direct sun exposure, particularly in the Australian climate.
- Tazarotene is not suitable during pregnancy; use reliable contraception if of childbearing potential, and inform your doctor of any pregnancy plans.
- Store below 25°C and keep out of reach of children.
Alternative Treatment Options
- Adapalene (Differin): Another topical retinoid, less irritating; available by prescription and over-the-counter for acne.
- Tretinoin (Retin-A, Retrieve): Older retinoid, similar efficacy; more photosensitising.
- Benzoyl peroxide: Non-prescription; effective for mild acne, may be combined with antibiotics.
- Topical antibiotics (clindamycin, erythromycin): For acne; sometimes combined with retinoids.
- Calcipotriol (for psoriasis): A vitamin D analogue; less irritating.
- Oral therapies: Considered for severe or resistant cases (requires specialist input).
Many alternatives (e.g. adapalene, tretinoin) are reimbursed by the Pharmaceutical Benefits Scheme (PBS) in specific indications. Discuss with your pharmacist or doctor for the best option.
Legal, Registration, and Reimbursement Status in Australia
- TGA (Therapeutic Goods Administration) Registration: Tazarotene is registered for topical use in acne and psoriasis.
- Legal status: Schedule 4 (Prescription Only); cannot be supplied without a doctor’s script.
- PBS status: Not typically reimbursed for acne, psoriasis indications—patients usually pay full price.
- Supply chains: Widely stocked in community pharmacies; may require ordering in regional areas.
Latest Research & Clinical Guidance (2022–2025)
- Recent guidelines (Australasian College of Dermatologists, 2022) recommend tazarotene as a safe and effective option for facial acne and mild psoriasis, with care regarding irritation and pregnancy safety (Australasian Journal of Dermatology, 2023).
- A 2022 meta-analysis in the British Journal of Dermatology confirms tazarotene’s comparable efficacy to other topical retinoids but highlights its higher irritation rate.
- Australian recommendations emphasise tailored regimens to balance efficacy with tolerability, particularly in sun-exposed populations.
Availability and Delivery
| Popular Pack Size | Indicative Pharmacy Price (AUD, 2024) | Estimated Delivery Time (Courier) |
|---|---|---|
| 30g gel/cream, 0.05% or 0.1% | $45–$65 | 1–2 days (Sydney, Melbourne, Brisbane), 2–5 days (Perth, Adelaide, Hobart, regional areas) |
| 60g gel/cream, 0.05% or 0.1% | $85–$110 | 1–2 days (metro); 2–5 days (regional/remote) |
Many pharmacies can arrange express delivery or click-and-collect. Always ensure you have a valid prescription.
Frequently Asked Questions (FAQ)
- How long does it take to see results with Tazorac?
Most patients notice improvements after 2–4 weeks of regular use, but optimal results can take 3 months. Mild irritation early on is common and usually subsides. - Can I use Tazarotene with other skincare products?
Yes, but avoid using other medicated creams (like benzoyl peroxide or strong exfoliants) at the same time unless advised by your healthcare provider. Always use a gentle moisturiser alongside. - Is it safe to use Tazarotene during pregnancy or breastfeeding?
No, tazarotene is not safe during pregnancy and should be avoided. If you become pregnant while using it, stop immediately and consult your doctor. - What should I do if my skin becomes very irritated?
Reduce application frequency, use gentle moisturiser, and avoid other irritating products. If symptoms persist, see your pharmacist or doctor. - Do I need to use sunscreen while on Tazarotene?
Absolutely. Tazarotene increases skin sensitivity to sunlight. Use a broad-spectrum SPF50+ sunscreen and wear protective clothing, especially with Australia’s intense UV.
Always speak with your pharmacist or healthcare provider for individual advice. This page does not replace medical consultation. For more product or availability information, contact your local pharmacy or visit the TGA’s official website.
