Retin-A is a brand name form of the drug tretinoin which is derived from vitamin A, and is used to improve fine wrinkles, dark spots or rough skin caused by sun damage and aging. It doesn't completely or permanently erase skin problems and it does have potential side effects, so it is always used under the supervision of a physician, sometimes in combination with other therapies.
History
In 1986, Dr. Albert M. Kligman, professor of dermatology at the University of Pennsylvania School of Medicine in Philadelphia, first noticed the anti-wrinkling effects of tretinoin when patients he was treating for acne with the drug developed smoother, firmer skin. It has been extensively studied since, and in 1995, the FDA approved tretinoic acid for the purpose of fighting wrinkles. In 1997, Retin-A became one of the first products created for this purpose.
Considerations
Certain preexisting conditions may mean you're not a good candidate for Retin-A, including dermatitis, seborrhea, eczema or if you have a sunburn, because using Retin-A could cause or increase the irritation associated with these conditions. Retin-A is also not recommended if you are already taking aminocaproic acid, aprotinin, tetracycline or tranexamic acid, or for women who are pregnant. Retin-A treatment for wrinkles is not covered by many insurance companies, and the Consumer Guide to Plastic Surgery says that annual costs for Retin-A treatment can average about $750 or more for a daily skincare regimen, based on 2008 prices.
Usage
Retin-A comes in three forms: cream, gel or a topical solution, and in various strengths, from 0.05 percent to 0.1 percent. It's generally prescribed to be used once daily at bedtime. Before applying you should wash your skin with a mild cleanser using your fingers, and not a washcloth or sponge--to avoid irritation--then patting the face dry. You should wait 20 to 30 minutes before using Retin-A, because applying it to wet skin can also irritate the skin.
Benefits
Dr. G. Todorov of the Smart Skin Care Guide says that the tretinoin in Retin-A works by triggering molecular switches in skin cells called retinoid receptors, which affect many intracellular processes including cell growth, synthesis of collagen and elastin, and possibly the cell's lifespan clock. It also inhibits the enzymes, known as matrix metalloproteinases (MMPs), that break down collagen and elastin, the skin's key structural proteins. As we age, MMPs become overactive and contribute to wrinkles and sagging skin. Retin-A can reduce wrinkles within six weeks and improvement may continue for up to a year, with continued use.
Side Effects
Retin-A can cause your skin to be irritated and flaky with some burning or tingling, particularly at the start of treatment, although in most cases the skin will adapt. For irritation, a moisturizer or low-dose corticosteroid cream may help. Another problem is increased sun sensitivity, so use a daily sunscreen with a high sun protection factor. In very rare cases, darkening of the treated skin may occur.
If side effects persist, they can lead to skin damage and accelerated aging. If you have very sensitive skin, Dr. Kligman suggests applying Retin-A once every third day and then every second day, until your skin adjusts, or start with a lower strength and increase it gradually. The Mayo Clinic adds that in some animal studies, tretinoin has been shown to cause skin tumors to develop faster when the treated area is exposed to sunlight or a sunlamp, but other studies have not shown the same result.
Tips & Warnings
Store Retin-A at room temperature, away from heat, moisture, light and the reach of children. The gel product is flammable and should be kept away from heat and fire. Avoid using harsh products on skin treated with Retin-A to prevent skin irritation, including acne or peeling agents, products with large amounts of alcohol, like astringents or after-shave lotions. Certain hair care products like permanents or hair removal treatments may also need to be avoided.
Dr. Kligman recommends using Retin-A early in life to get a head start on wrinkle prevention, not waiting until you're 40 or 50 and already have many wrinkles and blotches. Once you start treatment, you may need to maintain it the rest of your life, because once you stop using the drug, the wrinkles will return.
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