Retinol-induced Periorbital and Malar Irritant Dermatitis following over-the-counter Cosmetic Use: A Pharmacovigilance Case Report

Background: Topical retinoids are widely used in dermatology and cosmetic formulations for antiaging, acne, and hyperpigmentation treatment.Although generally well-tolerated, they may cause local cutaneous adverse reactions-particularly in sensitive facial regions such as the periorbital area, where skin is thinner and more permeable than elsewhere on the face.Case description: A 21-year-old female presented to the dermatology outpatient department with bilateral periorbital burning, erythema, and dry flaky skin 3 days after self-applying an over-the-counter (OTC) retinol cream to her entire face at night.Dermatological examination confirmed bilateral periorbital erythema and malar erythematous patches.The suspected product was discontinued, and symptomatic treatment was initiated.Complete recovery occurred within 5 days.Assessments: Causality assessment using the Naranjo Adverse Drug Reaction (ADR) Probability Scale yielded a score of +5, indicating a probable ADR.The WHO-UMC causality system classified the reaction as probable/likely.Severity assessment using the Modified Hartwig and Siegel Scale classified it as level 2 (mild), and the Schumock and Thornton Preventability Scale classified the reaction as probably preventable.Conclusion: This case underscores the risk of irritant dermatitis associated with unsupervised OTC use of cosmetic retinol cream, especially over sensitive facial areas.Enhanced public awareness and pharmacovigilance reporting are essential to ensure the safe use of topical retinoids.