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Favre-Racouchot Syndrome (Nodular Elastosis With Cysts and Comedones) Medication

  • Author: Robert P Feinstein, MD; Chief Editor: Dirk M Elston, MD  more...
Updated: Sep 08, 2015

Medication Summary

In general, the most effective medication has been the use of topical retinoids including tretinoin, adapalene, or tazarotene.


Retinoid-like Agents

Class Summary

Retinoid-like agents are the treatment of choice in the elimination of comedones. These medications assist in the removal of the comedones and may reduce the appearance of actinic damage in the area. More severe cases have been treated with oral isotretinoin, but oral therapy should be reserved for severe cases refractory to topical therapy.

Tretinoin topical (Avita, Retin-A, Retissa, Renova)


Tretinoin inhibits microcomedo formation and eliminates lesions. It makes keratinocytes in sebaceous follicles less adherent and easier to remove. Tretinoin is available as 0.025, 0.05, and 0.1% creams and as 0.01 and 0.025% gels. Cream formulations usually are well tolerated. Individuals may begin with the 0.025% cream. Those who do not respond to this concentration may require the 0.05% or 0.1% concentration.

Adapalene (Differin)


Adapalene modulates cellular differentiation, inflammation, and keratinization. It may be tolerated by individuals who cannot tolerate tretinoin creams. A therapeutic response can be expected following 8-12 weeks of therapy. Adapalene is available as 0.1% gel or solution.

Tazarotene (Tazorac, Avage)


Tazarotene is a retinoid prodrug whose active metabolite modulates differentiation and proliferation of epithelial tissue; it may also have anti-inflammatory and immunomodulatory properties.

Isotretinoin (Amnesteem, Claravis, Sotret)


Isotretinoin is an oral agent that treats serious dermatologic conditions. Isotretinoin is the synthetic 13-cis isomer of the naturally occurring tretinoin (trans-retinoic acid). Both agents are structurally related to vitamin A.

Isotretinoin decreases sebaceous gland size and sebum production. It may inhibit sebaceous gland differentiation and abnormal keratinization.

Isotretinoin should only be prescribed by individuals who are completely familiar with the drug and appropriate prescribing practices and precautions. A US Food and Drug Administration–mandated registry is now in place for all individuals prescribing, dispensing, or taking isotretinoin. For more information on this registry, see iPLEDGE. This registry aims to further decrease the risk of pregnancy and other unwanted and potentially dangerous adverse effects during a course of isotretinoin therapy.

Contributor Information and Disclosures

Robert P Feinstein, MD Associate Clinical Professor, Department of Dermatology, Columbia University College of Physicians and Surgeons

Robert P Feinstein, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Noah Worcester Dermatological Society, Phi Beta Kappa

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Edward F Chan, MD Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine

Edward F Chan, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Andrea Leigh Zaenglein, MD Professor of Dermatology and Pediatrics, Department of Dermatology, Hershey Medical Center, Pennsylvania State University College of Medicine

Andrea Leigh Zaenglein, MD is a member of the following medical societies: American Academy of Dermatology, Society for Pediatric Dermatology

Disclosure: Received consulting fee from Galderma for consulting; Received consulting fee from Valeant for consulting; Received consulting fee from Promius for consulting; Received consulting fee from Anacor for consulting; Received grant/research funds from Stiefel for investigator; Received grant/research funds from Astellas for investigator; Received grant/research funds from Ranbaxy for other; Received consulting fee from Ranbaxy for consulting.

  1. Favre M. Sur une kystique des appareils pilo-sebaces localis ertaines r'ons de la face. Bull Soc Fr Dermatol Syph. 1932. 39:93-6.

  2. Favre M, Racouchot J. [Nodular cutaneous elasteidosis with cysts and comedones.]. Ann Dermatol Syphiligr (Paris). 1951 Nov-Dec. 78(6):681-702. [Medline].

  3. Patterson WM, Fox MD, Schwartz RA. Favre-Racouchot disease. Int J Dermatol. 2004 Mar. 43(3):167-9. [Medline].

  4. Cardoso F, Nakandakari S, Zattar GA, Soares CT. Actinic comedonal plaque-variant of Favre-Racouchot syndrome: report of two cases. An Bras Dermatol. 2015 Jun. 90 (3 Suppl 1):185-7. [Medline].

  5. Keough GC, Laws RA, Elston DM. Favre-Racouchot syndrome: a case for smokers' comedones. Arch Dermatol. 1997 Jun. 133(6):796-7. [Medline].

  6. Vogel S, Muhlstadt M, Molin S, Ruzicka T, Schneider J, Herzinger T. Unilateral favre-racouchot disease: evidence for the eiological role of chronic solar damage. Dermatology. 2013. 226:32-4. [Medline].

  7. Breit S, Flaig MJ, Wolff H, Plewig G. Favre-Racouchot-like disease after radiation therapy. J Am Acad Dermatol. 2003 Jul. 49(1):117-9. [Medline].

  8. Friedman SJ, Su WP. Favre-Racouchot syndrome associated with radiation therapy. Cutis. 1983 Mar. 31(3):306-10. [Medline].

  9. Hoff NP, Reifenberger J, Boike E, Homey B, Gerber PA. Radiation-induced Favre-Racouchot disease. Hautarzt. Oct., 2012. 10:766-7. [Medline].

  10. Lim HW, James WD, Rigel DS, Maloney ME, Spencer JM, Bhushan R. Adverse effects of ultraviolet radiation from the use of indoor tanning equipment: time to ban the tan. J Am Acad Dermatol. 2011 May. 64(5):893-902. [Medline].

  11. Adams BB, Chetty VB, Mutasim DF. Periorbital comedones and their relationship to pitch tar: a cross-sectional analysis and a review of the literature. J Am Acad Dermatol. 2000 Apr. 42(4):624-7. [Medline].

  12. Morgan MB, Stevens GL, Somach S. Multiple follicular cysts, infundibular type with vellus hairs and solar elastosis of the ears: a new dermatoheliosis?. J Cutan Pathol. 2003 Jan. 30(1):29-31. [Medline].

  13. Lewis KG, Bercovitch L, Dill SW, Robinson-Bostom L. Acquired disorders of elastic tissue: part I. Increased elastic tissue and solar elastotic syndromes. J Am Acad Dermatol. 2004 Jul. 51(1):1-21; quiz 22-4. [Medline].

  14. Sanchez-Yus E, del Rio E, Simon P, Requena L, Vazquez H. The histopathology of closed and open comedones of Favre-Racouchot disease. Arch Dermatol. 1997 Jun. 133(6):743-5. [Medline].

  15. Kligman AM, Plewig G, Mills OH Jr. Topically applied tretinoin for senile (solar) comedones. Arch Dermatol. 1971 Oct. 104(4):420-1. [Medline].

  16. Sharkey MJ, Keller RA, Grabski WJ, McCollough ML. Favre-Racouchot syndrome. A combined therapeutic approach. Arch Dermatol. 1992 May. 128(5):615-6. [Medline].

  17. English DT, Martin GC, Reisner JE. Dermabrasion for nodular cutaneous elastosis with cysts and comedones. Favre-Racouchot syndrome. Arch Dermatol. 1971 Jul. 104(1):92-3. [Medline].

  18. Mohs FE, McCall MW, Greenway HT. Curettage for removal of the comedones and cysts of the Favre-Racouchot syndrome. Arch Dermatol. 1982 May. 118(5):365-6. [Medline].

  19. Mavilia L, Campolmi P, Santoro G, Lotti T. Combined treatment of Favre-Racouchot syndrome with a superpulsed carbon dioxide laser: report of 50 cases. Dermatol Ther. 2010 Jan-Feb. 23 Suppl 1:S4-6. [Medline].

  20. Rai S, Madan V, August PJ, Ferguson JE. Favre Racouchot Syndrome; A novel two- step treatment approach using the carbon dioxide laser. Br J Dermatol. Nov 2013. [Full Text].

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