Tretinoin treatment before carbon-dioxide laser resurfacing: a clinical and biochemical analysis.

Background: Tretinoin is often prescribed before laser resurfacing in an attempt to enhance results.

Objective: We sought to assess the clinical and biochemical effects of preoperative tretinoin use before laser resurfacing.

Methods: Patients were randomized to apply tretinoin to one forearm and placebo to the other for 3 weeks. Patients' photodamaged forearms were focally treated by carbon-dioxide laser resurfacing. Biopsy specimens were obtained at baseline and various times posttreatment. Real-time polymerase chain reaction technology was used to quantify messenger RNA levels of types I and III procollagen and matrix metalloproteinases-1, 3, and 9. Wounds were assessed for degree of re-epithelialization using a computer graphics-generated template. A colorimeter was used to quantify postoperative erythema.

Results: No substantial differences in either biochemical markers or clinical end points were identified between tretinoin and placebo pretreated forearms.

Conclusions: We found no evidence of enhanced collagen formation, accelerated re-epithelialization, or quicker resolution of postoperative erythema with tretinoin pretreatment before laser resurfacing.