Dowling Oration delivered at the Royal College of Physicians, London, Friday 5 June 1998. Retinoids: renaissance and reformation

Abstract

There is confusion as to the cutaneous signs of ageing. For the most part the features of photoageing, namely actinic lentigines and wrinkling, are misinterpreted as features of ageing. Wrinkling is associated with a loss of collagens from the papillary dermis resulting from imperfect remodelling of the dermal extracellular matrix following sun exposure. Retinoids are either derivatives of vitamin A or synthetic ligands of nuclear retinoid receptors. Retinoid receptors, notably retinoic acid receptor gamma and retinoid X receptor alpha are present in human skin. Topically applied all-trans retinoic acid can repair and probably prevent photoageing of the skin by modulation of collagen synthesis in the dermis. There is emerging evidence that intrinsic ageing of the skin is also amenable to reversal by topical retinoids.

Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety

“…The newest retinoids are antagonists, which have potent anti-inflammatory activity and look promising as topical treatment for psoriasis (Griffiths et al 1998). …”

Topical retinoids in the treatment of photoaging

“…This issue of irritancy and efficacy is not fully resolved. Even a very low irritation may be required to produce the desirable clinical effects 29 …”