Skin Care :: Wrinkles and antioxidants – Vitamin A Topical Products

Vitamin A is important for skin health and UV radiation produces deficiencies in the skin. Topical products containing natural forms of vitamin A (retinol, retinaldehyde) or vitamin A derivatives called retinoids (tretinoin, tazarotene) have proven to be beneficial for skin damaged by the sun and also by natural aging.

Tretinoin (Retin-A). Tretinoin (known commercially as Retin-A) is the only topical agent approved for treating photoaging and is available in prescription form (Avita, Renova, Differin). This agent produces a rosy glow and reduces fine and large wrinkles, liver spots, and surface roughness. It also may help prevent more serious effects of ultraviolet radiation. Tretinoin may be applied to face, neck, chest, hands, and forearm and should be applied at least twice a week. Noticeable improvement takes from two to six months. Because Retin-A increases a person’s sensitivity to the sun, a thin coat is best administered at bedtime. A sunblock should be worn during the day, and overexposure to the sun should be avoided.

Almost all patients experience redness, scaling, burning, and itching after two or three days that can last up to three months. In women who experience irritation, a daytime moisturizer or low-dose corticosteroid cream, such as 1% hydrocortisone, may help. There is some concern that overuse of high-dose tretinoin may cause excessive skin thinness over time. Studies now suggest that low concentrations (as low as .02%) of tretinoin can produce significant improvements in wrinkles and skin color, with less irritation than at higher doses. Oral tretinoin causes birth defects, and women should avoid even topical Retin-A when pregnant or trying to conceive.

Retinol. Retinol, a natural form of vitamin A, could not, until recently, be used in skin products because it was unstable and easily broken down by UV radiation. Stable preparations are now sold over the counter. In the right concentrations, retinol may be as effective as tretinoin and studies indicate that it has fewer side effects. An animal study suggests that adding antioxidant creams (such as those containing vitamins C or E) may offer added protection against degradation of retinol, but not tretinoin. The FDA warns that over-the-counter retinol skin products are unregulated; the amount of active ingredients is unknown, and some preparations, in fact, may contain almost no retinol.

Tazarotene. Tazarotene (Tazorac, Zorac) is a retinoid used for acne and psoriasis. One short-term study suggested that it may be as effective as tretinoin and even slightly better at high doses. At such high doses, however, it can cause very severe irritation. Redness and peeling may be reduced by administering tretinoin first to get the skin acclimated. More research is needed to determine if it produces any long-lasting significant benefits. As with any vitamin A derivative, it should be avoided by pregnant women and those who may become pregnant.

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