by Dr C de Villiers
Retinoids have demonstrable efficacy in the treatment of sun-damaged skin. This group of substances comprising vitamin A and its natural and synthetic derivatives were first used in dermatology in 1943 for acne. However, since then retinoids applied to the skin have been used in treatment of various skin conditions including photo-ageing.
Photo damage of the skin occurs as a result of cumulative sun exposure over the years and is characterised by wrinkling, easy bruising, inelasticity, mottled pigmentation, roughness and enlarged skin veins. The way topical retinoids improve sun-ageing is probably by modifying cellular differentiation.
The following retinoids are of use in sun related skin ageing:
– TRETINOIN (retinoic acid) is the most potent anti-sun damage retinoid. However, it has the potential to cause skin irritation, so frequency of application needs to be adjusted according to the degree of irritation, ie only every second or third night.
– RETINOL (vitamin A alcohol) has proven anti-sun ageing effects but is less potent than tretinoin. Also, it’s less irritating. It gets converted in the skin to retinoic acid to have its effect.
– RETIALDEHYDE is metabolised in the skin to retinoic acid which is a well-known anti-ageing agent. It’s also less irritating than tretinoin. Retinaldehyde is only effective when it’s converted to retinoic acid in the skin.
– ADAPALENE is a third-generation retinoid. It’s used primarily as a treatment for acne but can be used as a second-line treatment for sun ageing in patients who don’t tolerate the abovementioned conventional retinoids.
The most common side-effects with use of retinoids on the skin are itchiness, burning, redness and peeling. This may necessitate using them less often and counteracting the irritating effects with a moisturiser. Patients using retinoids should also use sunscreens during the day as they make the skin more sun-sensitive. They shouldn’t be used during pregnancy.
Topical retinoids are very valuable agents in combatting skin ageing in particular to help improve fine wrinkles, roughness and mottled pigmentation.
PRODUCTS CONTAINING RETINOIDS AVAILABLE AT LASERMED AND DERMASHOP:
Zone: Day Cream, Night Cream, Eye Gel
Dermaquest: Essential Moisturiser, Retinol Peptide Youth Serum, Nourishing Peptide Rich, Retexture Serum
Skin Tech: Nutritive Cream
Neostrata: Renewal Cream and Retinol + NAG Complex (only available directly at Lasermed, not through Dermashop)