Is tretinoin still a key agent for photoaging management?

Mini Rev Med Chem

Faculdade de Farmacia da Universidade de Lisboa, Campus do Lumiar, Estrada do Paco do Lumiar, 22, Edifício F, R/C, 1649-038 Lisboa, Portugal.

Published: June 2015

AI Article Synopsis

  • This review examines the impact of UV radiation on skin aging (photoaging) and highlights tretinoin (all-trans retinoic acid) as an effective treatment for reversing these effects.
  • Tretinoin works by activating retinoic acid receptors, leading to changes in gene expression that reduce skin cell proliferation, promote differentiation, and inhibit tumor growth.
  • The combined use of tretinoin with other treatments, like hydroquinone and corticosteroids, remains the best approach for conditions like melasma, although more clinical trials are needed to support other new therapies.

Article Abstract

Unlabelled: BACKGROUND & SCOPE OF THE REVIEW: This review focuses on the UV radiation effects on skin, emphasizing the photoaging process, and the photoprotection conferred by tretinoin (all-trans retinoic acid or ATRA). Tretinoin is still the best tested retinoid to reverse photoaged skin.

Major Conclusions: Tretinoin can be used for photoaging treatment or combined treatment by different mechanisms. It binds to and activates retinoic acid receptors, inducing changes in gene expression that leads to cell differentiation, decreased cell proliferation, and inhibition of tumourigenesis. It has been demonstrated that photoaging resulting from UV-B radiation can be treated by retinoid formulations. Pretreatment of human skin with tretinoin blocks dermal matrix degradation followed by sun exposure, inhibiting the induction of the activated protein-1 (AP-1) transcription factor and AP-1 regulated matrix-degrading metalloproteinases. GENERAL SIGNIFICANCE AND INTEREST: Tretinoin should be considered as a key factor as it is the most potent and best-studied retinoid. In addition, the development of advanced drug delivery systems, especially novel nanoformulations, has contributed to overpass some technical drawbacks besides the skin irritation potential. The triple combination of tretinoin, hydroquinone and corticosteroids is still considered the gold standard for melasma. Although there are other novel therapeutic approaches, more high-quality clinical trials are still needed.

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Source
http://dx.doi.org/10.2174/1389557514666140820102735DOI Listing

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