Consumers are now aware that the anti-aging properties of Retin-A, a prescription topical treatment for acne, also decreased the appearance of wrinkles and smoothed skin, in addition to a reducing acne symptoms. It is now the sought-after medical treatment for correcting aging skin symptoms, which is considered a cosmetic usage. It is very effective, however requires a trip to the physician and a prescription. Most health insurance plans will not cover Retin-A or tretinoin for the cosmetic purposes of treating aging skin, so can be very costly.
The active ingredient in Retin-A and tretinoin (both vitamin A derivatives) is retinoic acid. These are the only topicals, to date, to receive FDA approval for anti-aging and correcting sun damage properties. Research shows that retinoids are effective in preventing and treating collagen loss caused by photodamage, and aid in expelling embedded pigment from photo-aged skin. UV exposure decreases collagen types I and III resulting in loss of firmness and elasticity. Treatment of the skin with retinoids (retinol, Retin-A, tretinoin, retinoic acid) prevents the loss of these types of collagen. In addition, studies demonstrated that application of tretinoin or retinol inhibits the induction of matrix metalloproteinase (MMPS) which are in part, responsible for collagen degradation.
Side effects of retinoids can include irritation, desquamation, redness and flakey skin. It is notable that patients with sensitive skin should use lower concentrations of Retin-A and tretinoin (0.025% rather than 0.1%) or, alternatively, lower concentrations of retinol. Accordingly, retinol should be present in concentrations of at least 0.5% to 1.1%, formulated and packaged properly (to minimize irritation and oxidation) to be optimally effective. Those with sensitive skin not only need to use lower concentrations, but also need to start slowly. To begin a regime of retinol at 0.5% every other night will allow to skin to gradually adjust to the use of retinol. Clients should be advised to not stop the usage, but to use it less frequently to become tolerant.
The effectiveness of retinol is related to the proven-effectiveness of tretinoin. Retinol is classified as a cosmetic rather than a drug because it must first be converted to retinoic acid within the skin to be effective. It does not require a prescription so is the preferred anti-aging treatment by estheticians. In general, retinol is considered to be about 10 times less potent than Retin-A, and thus higher concentrations of retinol are needed to achieve similar efficacy to retinoic acid. Although retinol needs to be present in higher quantities than tretinoin or Retin-A to be effective, patients typically experience lower levels of irritation using retinol products. Similarly, retinyl palmitate is a combination of retinol and palmitic acid and so it must be converted to retinaldehyde and then to retinol, then to retinoic acid within the skin in order to be effective. Because of the multiple conversions, retinyl palmitate tends to be milder, but also, far less effective.
Retinoids are thereby considered to be excellent prevention and treatment against the signs of aging caused by UV exposure.