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Topical Tretinoin for Treatment of Photodamaged Skin: A Multicenter Study

Topical Tretinoin for Treatment of Photodamaged Skin: A Multicenter Study Abstract • The clinical and histologic effects of a new emollient cream formulation of topical tretinoin at concentrations of 0.05% and 0.01% were examined in 251 subjects with mild to moderate photodamaged facial skin in a randomized, doubleblind, vehicle-controlled, multicenter study. Seventy-nine percent of the subjects who received 0.05% tretinoin for 24 weeks showed overall improvement in photodamaged skin compared with improvement in 48% of the vehicle-treated control subjects. Significant reductions were found in fine wrinkling, mottled hyperpigmentation, roughness, and laxity after 0.05% tretinoin therapy when compared with controls. In addition, histologic changes of increased epidermal thickness, decreased melanin content, and stratum corneum compaction provide independent evidence supporting clinical improvement. Side effects of erythema, peeling, and stinging were usually mild and well tolerated. (Arch Dermatol. 1991;127:659-665) References 1. Gilchrest BA. Skin and Aging Processes . Boca Raton, Fla: CRC Press; 1984. 2. Kligman AM. Early destructive effects of sunlight on human skin . JAMA . 1969;210:2377-2380.Crossref 3. Lavker RM. Structural alterations in exposed and unexposed skin . J Invest Dermatol. 1979;73:59-66.Crossref 4. Uitto J. Connective tissue biochemistry of the aging dermis: age-related alterations in collagen and elastin . Dermatol Clin. 1986;4:443-446. 5. Gilchrest BA, Blog FB, Szabo G. Effects of aging and chronic sun exposure on melanocytes in human skin . J Invest Dermatol. 1979;73:141-143.Crossref 6. Kligman AM, Graham JA. The psychology of cutaneous aging . In: Balin AK, Kligman AM, eds. Aging and the Skin . New York, NY: Raven Press; 1989;347-355. 7. Taylor CR, Stern RS, Leyden JJ, Gilchrest BA. Photoaging/ photodamage and photoprotection . J Am Acad Dermatol. 1990;22:1-15.Crossref 8. Engel A, Johnson M-L, Haynes SG. Health effects of sunlight exposure in the United States . Arch Dermatol. 1988;124:72-79.Crossref 9. Kligman LH, Duo CH, Kligman AM. Topical retinoic acid enhances the repair of ultraviolet damaged dermal connective tissue . Connect Tissue Res. 1984;12:139-150.Crossref 10. Kligman AM, Grove GL, Hirose R, Leyden JJ. Topical tretinoin for photoaged skin . J Am Acad Dermatol. 1986;15:836-859.Crossref 11. Weiss JS, Ellis C, Headington JT, Tincoff T, Hamilton TA, Voorhees JJ. Topical tretinoin improves photoaged skin: a doubleblind vehicle-controlled study . JAMA . 1988;259:527-532.Crossref 12. Zelickson AS, Mottaz JH, Weiss JS, Ellis CN, Voorhees JJ. Topical tretinoin in photoaging: an ultrastructural study . J Cutan Aging Cosmetic Dermatol. 1988;1:41-47. 13. Leyden JJ, Grove GL, Grove MJ, Thorne EG, Lufrano L. Treatment of photodamaged facial skin with topical tretinoin . J Am Acad Dermatol. 1989;21:638-644.Crossref 14. Lever L, Kumar P, Marks R. Topical retinoic acid for treatment of solar damage . Br J Dermatol. 1990;122:91-98.Crossref 15. Grove GL, Grove MJ. Objective methods for assessing skin surface topography noninvasively . In: Leveque JL, ed. Cutaneous Investigations in Health and Disease . New York, NY: Marcel Dekker Inc; 1988:1-32. 16. Grove GL. Dermatological applications of the Magiscan image analyzing computer . In: Marks R, Payne PA, eds. Bioengineering and the Skin . New York, NY: MTP Press Ltd; 1979:173-180. 17. Grove GL, Grove MJ, Leyden JJ. Optical profilometry: an objective method for quantification of facial wrinkles . J Am Acad Dermatol. 1989;21:631-637.Crossref 18. McDowell EM, Trump BF. Histologic fixatives suitable for diagnostic light and electron microscopy . Arch Pathol Lab Med. 1976;100:405-414. 19. Grizzle JE, Starmer CF, Koch GG. Analysis of categorical data by linear models . Biometrics . 1969;25:489-504.Crossref 20. Hochberg Y, Tamhane AC, eds. Multiple Comparison Procedures . New York, NY: John Wiley & Sons Inc; 1987:57-59. 21. Grove GL, Grove MJ, Zerweck CR, Leyden JJ. Determination of topical tretinoin effects on cutaneous microcirculation in photoaged skin by laser doppler velocimetry . J Cutan Aging Cosmetic Dermatol. 1988;1:27-32. 22. Petkovich M, Brand J, Krust A, Chambon P. A human retinoic acid receptor which belongs to the family of nuclear receptors . Nature . 1987;330:444-450.Crossref 23. Brand N, Petkovich M, Krust A, et al. Identification of a second human retinoic acid receptor . Nature . 1988;332:850-853.Crossref 24. Chytil R. Retinoic acid: biochemistry and metabolism . J Am Acad Dermatol. 1986;15:741-747.Crossref 25. Sporn MB, Roberts AB, Roche NS, Kagechika H, Shudo K. Mechanism of action of retinoids . J Am Acad Dermatol. 1986;15:756-764.Crossref 26. Eichner R. Epidermal effects of retinoids: in vitro studies . J Am Acad Dermatol. 1986;15:789-797.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1991.01680040067005
Publisher site
See Article on Publisher Site

Abstract

Abstract • The clinical and histologic effects of a new emollient cream formulation of topical tretinoin at concentrations of 0.05% and 0.01% were examined in 251 subjects with mild to moderate photodamaged facial skin in a randomized, doubleblind, vehicle-controlled, multicenter study. Seventy-nine percent of the subjects who received 0.05% tretinoin for 24 weeks showed overall improvement in photodamaged skin compared with improvement in 48% of the vehicle-treated control subjects. Significant reductions were found in fine wrinkling, mottled hyperpigmentation, roughness, and laxity after 0.05% tretinoin therapy when compared with controls. In addition, histologic changes of increased epidermal thickness, decreased melanin content, and stratum corneum compaction provide independent evidence supporting clinical improvement. Side effects of erythema, peeling, and stinging were usually mild and well tolerated. (Arch Dermatol. 1991;127:659-665) References 1. Gilchrest BA. Skin and Aging Processes . Boca Raton, Fla: CRC Press; 1984. 2. Kligman AM. Early destructive effects of sunlight on human skin . JAMA . 1969;210:2377-2380.Crossref 3. Lavker RM. Structural alterations in exposed and unexposed skin . J Invest Dermatol. 1979;73:59-66.Crossref 4. Uitto J. Connective tissue biochemistry of the aging dermis: age-related alterations in collagen and elastin . Dermatol Clin. 1986;4:443-446. 5. Gilchrest BA, Blog FB, Szabo G. Effects of aging and chronic sun exposure on melanocytes in human skin . J Invest Dermatol. 1979;73:141-143.Crossref 6. Kligman AM, Graham JA. The psychology of cutaneous aging . In: Balin AK, Kligman AM, eds. Aging and the Skin . New York, NY: Raven Press; 1989;347-355. 7. Taylor CR, Stern RS, Leyden JJ, Gilchrest BA. Photoaging/ photodamage and photoprotection . J Am Acad Dermatol. 1990;22:1-15.Crossref 8. Engel A, Johnson M-L, Haynes SG. Health effects of sunlight exposure in the United States . Arch Dermatol. 1988;124:72-79.Crossref 9. Kligman LH, Duo CH, Kligman AM. Topical retinoic acid enhances the repair of ultraviolet damaged dermal connective tissue . Connect Tissue Res. 1984;12:139-150.Crossref 10. Kligman AM, Grove GL, Hirose R, Leyden JJ. Topical tretinoin for photoaged skin . J Am Acad Dermatol. 1986;15:836-859.Crossref 11. Weiss JS, Ellis C, Headington JT, Tincoff T, Hamilton TA, Voorhees JJ. Topical tretinoin improves photoaged skin: a doubleblind vehicle-controlled study . JAMA . 1988;259:527-532.Crossref 12. Zelickson AS, Mottaz JH, Weiss JS, Ellis CN, Voorhees JJ. Topical tretinoin in photoaging: an ultrastructural study . J Cutan Aging Cosmetic Dermatol. 1988;1:41-47. 13. Leyden JJ, Grove GL, Grove MJ, Thorne EG, Lufrano L. Treatment of photodamaged facial skin with topical tretinoin . J Am Acad Dermatol. 1989;21:638-644.Crossref 14. Lever L, Kumar P, Marks R. Topical retinoic acid for treatment of solar damage . Br J Dermatol. 1990;122:91-98.Crossref 15. Grove GL, Grove MJ. Objective methods for assessing skin surface topography noninvasively . In: Leveque JL, ed. Cutaneous Investigations in Health and Disease . New York, NY: Marcel Dekker Inc; 1988:1-32. 16. Grove GL. Dermatological applications of the Magiscan image analyzing computer . In: Marks R, Payne PA, eds. Bioengineering and the Skin . New York, NY: MTP Press Ltd; 1979:173-180. 17. Grove GL, Grove MJ, Leyden JJ. Optical profilometry: an objective method for quantification of facial wrinkles . J Am Acad Dermatol. 1989;21:631-637.Crossref 18. McDowell EM, Trump BF. Histologic fixatives suitable for diagnostic light and electron microscopy . Arch Pathol Lab Med. 1976;100:405-414. 19. Grizzle JE, Starmer CF, Koch GG. Analysis of categorical data by linear models . Biometrics . 1969;25:489-504.Crossref 20. Hochberg Y, Tamhane AC, eds. Multiple Comparison Procedures . New York, NY: John Wiley & Sons Inc; 1987:57-59. 21. Grove GL, Grove MJ, Zerweck CR, Leyden JJ. Determination of topical tretinoin effects on cutaneous microcirculation in photoaged skin by laser doppler velocimetry . J Cutan Aging Cosmetic Dermatol. 1988;1:27-32. 22. Petkovich M, Brand J, Krust A, Chambon P. A human retinoic acid receptor which belongs to the family of nuclear receptors . Nature . 1987;330:444-450.Crossref 23. Brand N, Petkovich M, Krust A, et al. Identification of a second human retinoic acid receptor . Nature . 1988;332:850-853.Crossref 24. Chytil R. Retinoic acid: biochemistry and metabolism . J Am Acad Dermatol. 1986;15:741-747.Crossref 25. Sporn MB, Roberts AB, Roche NS, Kagechika H, Shudo K. Mechanism of action of retinoids . J Am Acad Dermatol. 1986;15:756-764.Crossref 26. Eichner R. Epidermal effects of retinoids: in vitro studies . J Am Acad Dermatol. 1986;15:789-797.Crossref

Journal

Archives of DermatologyAmerican Medical Association

Published: May 1, 1991

References