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They also function to disrupt the positive feedback mechanism involving local prostaglandin production that is responsible for further increasing estrogen levels in ectopic endometrial cells (34)

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With the exception of the 0.05% lotion (approved for use in children 9 years and older) and 0.05% gel (approved for use in children 10 years and older) formulations, safety and efficacy of topical tretinoin have not been established in neonates, infants and children under 12 years of age