Vitamin A derived products are widely used in the cosmetic industry and in dermatologic practice. The most common of the derivatives are the so called Retinoids. The Retinoids are widely used to control the cells from dividing and accumulating on the skin
Asides from their actions on the skin, retinoids have an important role in maintaining vision, regulation of bone growth and development of the immune system. Its role in tumor control and regulation is still not understood.
In the last 2 decades, several types of Retinoids have been developed and include:
- 1st generation retinoids: Retinol, retinal, tretinoin (Retin-A), isotretinoin and alitretinoin
- 2nd generation retinoids: Etretinate and its metabolite acitretin
- 3rd generation retinoids: Tazarotene, bexarotene and Adapalene.
Currently Retinoids are used to treat
- precancerous skin lesions
- photo aged skin
Tretinoin (Retin-A). Tretinoin is now widely used to treat photo aging and is available as a topical cream (Avita). When applied for several months, the drug produces a tighter looking skin with reduction in the fine lines. It has been claimed to reduce sun spots and improve the skin texture. Tretinoin can be applied on most parts of the body except the eye. It is initially applied only once a week and then as the skin irritation subsides one can increase the application to twice a week.
Not all individuals who use the drug have an improvement in the skin. About 60% will see some improvement after a period of 4-6 months. Because the drug can cause extreme sun sensitivity, wearing sunscreens is highly recommended.
Itching, burning and redness are common during the initial application of the drug. The redness and dryness can be diminished by applying a skin moisturizing agent at the same time. If the itch is severe, a low potency hydrocortisone cream may also help. Because Retinoids are known to cause fetal malformations, all women who are pregnant or thinking of conceiving, should keep away from this product.
Retinol has been around for many years but the stability of the compound has always been in question. It is available over the counter but most FDA studies indicate that the product is useless and is best avoided
Tazarotene (Tazorac) is a newer retinoid used to treat acne and psoriasis. It is not only effective but has much reduced side effects compared to Tretinoin. It has been promising for the treatment of psoriasis and acne.
As with any vitamin A derivative, it should be avoided by pregnant women and those who may become pregnant.