Retinoids in the Treatment of Skin Aging: an Overview of Clinical Efficacy and Safety


A 2006 review from Clinical Interventions in Aging (vol 1, no 4, p.327) reviewing scientific data on the various forms of retinol and the topical delivery systems to reverse the effects of photoaged skin. The authors observe that while the most effective form of retinol - tretinoin - is also associated with adverse reactions, the reactions can be overcome by using different forms of retinol or soothing agents. Finally, the authors conclude that retinol is effective for treating photoaged skin and that promising new forms of retinol hold the promise for more effective and less irritating solutions to prematurely aged skin.

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Aging of skin is an intricate biological process consisting of two types. While intrinsic or chronological aging is an inevitable process, photoaging involves the premature aging of skin occurring due to cumulative exposure to ultraviolet radiation...

Photoaging is the superimposition of photodamage on intrinsically aged skin generally bringing about premature aging. This specifi c damage occurs by chronic (multiple) exposure of the skin to UV light. Clinically, the skin becomes coarse; epidermis thickens (hyperplasia) initially and then thins (atrophy), there is laxity, sallowness with wrinkles, irregular hyperpigmentation, lentigines, and telangiectasias.

The retinoid family comprises vitamin A (retinol) and its natural derivatives such as retinaldehyde, retinoic acid, and retinyl esters, as well as a large number of synthetic derivatives...Vitamin A cannot be synthesized by the body; hence it needs to be supplied to the body. Naturally, it is present as retinyl esters and beta-carotene. The retinyl esters are converted to retinol before absorption from the intestine and back to retinyl esters for storage in the liver.

The most common and frequent adverse effect of topical retinoids are known as ‘retinoid reaction’, characterized by pruritus, burning sensation at the sites of application, erythema, peeling. It is more common with tretinoin and tazarotene than with isotretinoin, adapalene, retinol, and retinaldehyde...To counteract the symptoms of retinoid reaction, reduction in the frequency of application or switching to a less irritating retinoid is normally advised...

Amongst various antiaging agents, retinoids are the most promising agents that are available for the treatment of aging. Amongst retinoids, tretinoin is the most potent and best-studied retinoid. However, its irritation potential has prompted dermatologists to switch over to less irritating but comparably effective retinoids like adapalene and to some extent retinol and retinaldehyde. Receptor specific retinoids like seletinoid G have been developed with the same vision and have been found to be successful in small-scale studies.


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