Retin-A and Wax Epilation

To the Editor.—  This letter describes the occurrence of erosions at sites of wax epilation on the face in areas being treated with topical tretinoin (Retin-A) in two patients.

Report of Cases.—Case 1.—  A 27-year-old woman with type II skin, mild comedonal acne, and mild to moderate photodamage was treated with Retin-A cream (0.05% ) every third night. One month later, she had a "facial" and wax epilation of her eyebrows. The patient denied the presence of any erythema or irritation in the area prior to epilation. She had had both procedures performed multiple times in the past without problems, and was using no other topical medications at the time. On this occasion removal of the wax resulted in shiny, moist, fiery red, confluent erosions of the skin around both eyebrows, with marked periorbital edema. The wounds were treated with a topical antibiotic ointment and both areas healed without