Histologic evaluation of the long term effects of tretinoin on photodamaged skin

Bhawan, Jag; Olsen, Elise A.; Lufrano, Laura; Thorne, E. George; Schwab, B.; Gilchrest, Barbara A.

doi:10.1016/0923-1811(95)00432-7

Cited by 48 publications

(34 citation statements)

References 13 publications

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“…This finding is consistent with the results of a previous study. 12 In a long-term study such as ours, unavoidable long-term sun exposure to the face is expected to worsen epidermal cellular atypia over the study duration. Thus no further worsening in atypia with RA treatment would actually constitute an improvement in this parameter.…”

Section: Discussionmentioning

confidence: 98%

“…Data contradictory to ours that papillary dermal thickness is decreased (65%) by years of topical RA application, may be related in part to a suboptimal staining procedure used to identify the DRZ. 12 The use of VVG staining allowed clear visualization of DRZ above the area of solar elastosis. We confirmed the identity of this zone as collagen with the use of Masson-trichrome and Sirius Red stains.…”

Section: Discussionmentioning

confidence: 99%

“…In RA-treated photoaged human skin, DRZ results have been conflicting. One study reported a significant reduction in the thickness of papillary dermis after long-term RA treatment, 12 whereas another saw an increase. 13 The former study may have had difficulty visualizing the band because of suboptimal staining of the tissue, whereas the latter study provided no quantitative evaluation.…”

mentioning

confidence: 98%

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Long-term treatment of photoaged human skin with topical retinoic acid improves epidermal cell atypia and thickens the collagen band in papillary dermis

Cho

Lowe

Hamilton

et al. 2005

Journal of the American Academy of Dermatology

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 98%

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Long-term treatment of photoaged human skin with topical retinoic acid improves epidermal cell atypia and thickens the collagen band in papillary dermis

Cho

Lowe

Hamilton

et al. 2005

Journal of the American Academy of Dermatology

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“…Although not completely delineated at present, late effects of topical tretinoin (after 4 years of therapy) appear to involve reductions in the area of dermal elastosis and perivascu lar inflammation, both indicative of reversal of photodamage [32]. In biopsies taken after up to 4 years of treatment, epidermal mucin continued to increase whereas other histologic alterations, such as epidermal thickness, con tinued to regress to baseline levels or below.…”

Section: Treatment With Topical Tretinoinmentioning

confidence: 97%

Treatment Options for Photodamaged Skin

Griffiths¹

1997

Skin Pharmacol Physiol

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Photodamage of the skin can be a detriment to physical and psychological health with a consequent negative impact on both personal and professional life. Medical treatments for photodamaged skin include topical all-trans-retinoic acid (tretinoin) as well as moisturizers, chemical peels, dermabrasion, Α hydroxy acids and cosmetic surgery. Of these treatment options, only tretinoin has been subjected to large-scale, controlled studies to substantiate its clinical efficacy and long-term benefits. This review summarizes the use of various therapies and presents available clinical and histologic results of systematic trials, including the few studies of retinoid compounds other than tretinoin. Among the extensive data on topical tretinoin are long-term treatment results that provide evidence of ultrastructural changes. These histologic findings suggest that fundamental cellular effects may be responsible for the clinical benefits, which are sustained even when treatment frequency is reduced. It thus appears that tretinoin therapy at least partially restores photodamaged skin to the predamaged state.

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“…Profound epidermal effects have also been demonstrated in human skin, including the reversal of UV-induced atrophy with a decrease in atypia [7,8], a therapeutic effect on actinic keratoses [9] and a marked decrease in the density of melanin granules [10,11]. Since an early effect of tretinoin treatment is scaling and redness, it has been suggested that part of the beneficial effect of tretinoin is due to low-grade inflammation rather than a specific retinoid effect [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Peeling agents and irritants, unlike tretinoin, do not stimulate collagen synthesis in the photoaged hairless mouse

1996

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Tretinoin has been shown to stimulate the synthesis of collagen in photo-aged human and hairless mouse skin. It has been suggested that this partial reversal of photodamage by tretinoin is a consequence of low-grade inflammation. The purpose of this study was to compare the effect of tretinoin with a number of irritants and peeling agents on collagen synthesis. Hairless mice were irradiated thrice weekly for 10 weeks with UVB. In the 10-week postirradiation period, the mice were treated topically five times per week with tretinoin (0.05%), glycolic acid (10%), benzalkonium chloride (1.0%), sodium lauryl sulfate (5%), croton oil (5%) and the water - propylene glycol vehicle. Microscopic measurements showed that the tretinoin-induced zone of new collagen was twice the depth of that induced by irritants or vehicle. The salt-soluble collagen content was determined by HPLC analysis of hydroxyproline levels. Type III procollagen was quantified by radioimmunoassay. Tretinoin-treated skin had increased amounts of collagen and type III procollagen whereas irritant- and peeling agent-treated skins were similar to vehicle-treated controls. Immunofluorescence studies were confirmatory. These results demonstrate that these agents, unlike tretinoin, do not have the capacity to enhance collagen synthesis. Therefore, it is likely that the effect of tretinoin does not depend upon irritation.

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Histologic evaluation of the long term effects of tretinoin on photodamaged skin

Cited by 48 publications

References 13 publications

Long-term treatment of photoaged human skin with topical retinoic acid improves epidermal cell atypia and thickens the collagen band in papillary dermis

Long-term treatment of photoaged human skin with topical retinoic acid improves epidermal cell atypia and thickens the collagen band in papillary dermis

Treatment Options for Photodamaged Skin

Peeling agents and irritants, unlike tretinoin, do not stimulate collagen synthesis in the photoaged hairless mouse

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