We know that the sun, wind, ultraviolet light and other elements significantly speed up the aging process. The use of sunscreens as protection has greatly improved one’s ability to prevent some of the damage associated with extrinsic factors, but until rather recently there has been no way to reverse these changes short of surgery (in spite of the claims of some cosmetic companies).
As we age, the surface layer of our skin (the epithelium) thins out, and the cell renewal cycle takes longer. The older, less viable cells on the surface accumulate, causing the skin to have a dull, lifeless appearance. In addition, the proportion of “healthy cells” diminishes, and, as the circulation becomes sluggish, there is impaired nourishment to all layers of the skin.
The lower layer of the skin (the dermis) is composed of interlaced fibers of collagen and spring-like elastic fibers, as well as a mesh-work of blood vessels. All these components, likewise, deteriorate as we age, causing the skin to lose its elasticity and become wrinkled.
Retin-A is not a “new” product. Retin-A has long been used as a topical applicant in the treatment of acne. It has also been described in conjunction with the reduction of fine facial wrinkling.
Retin-A contains retinoic acid which is a derivative of vitamin A. It was discovered that the medication caused the scaly cells on the surface of the skin to slough off more rapidly, increased the number of healthy, viable cells in the epithelium and improved circulation. While this was helpful in improving acne, it was also effective in reversing some of the early signs of the aging process.
A article in the New England Journal of Medicine by a research group at the University of Michigan reported that collagen is significantly decreased in photo-damaged skin and that this process was partly reversed by treatment with Retin-A. This improvement was noted after 10-12 months, using a high strength of Retin-A. This research correlated well with what we have known for some time about Retin-A; namely that the skin improvement takes many months to achieve.
Retin-A comes in many forms (creams, lotions and gels) and many concentrations. The initial effects of Retin-A generally become evident about three weeks after treatment is started. Once begun, the treatment should be continued or the skin may revert back to its pretreatment condition.
You can expect there to be a light tingling sensation after you apply the lotion. This may occur immediately or as long as a few weeks after beginning its use; it is a normal response, so don’t become alarmed. After a while, you will notice a nice, light pink blushing of the skin- this is also a normal response. Excessive redness, swelling or blistering is abnormal. If these phenomena occur, however, you should discontinue the medication and call your physician.
The risks of using Retin-A include an increased sensitivity to the sun and retinoid dermatitis. This results in burning, redness and stinging if skin tissues. It is important that patients be aware of this factor. It is noticed that individuals who have dry skin are more sensitive to this reaction. Individuals must use moisturizers and sunscreens (SPF 30 or greater) when using Retin-A.
Results are encouraging, but it must be remembered that Retin-A is not a substitute for surgery. It is intended to complement many of the facial plastic surgical procedures(facelifting, eyelid plastic surgery and chemical peels) and aesthetic procedures (Obagi skincare, glycolic peels, microdermabrasions, and prolight photo facial) that are at our disposal.
The aging process results in a number of changes, which affect the skin, subcutaneous (below the skin) tissue, muscles and skeletal structures. Facial chemical peels and topical applications of ointments, such as Retin-A only affect the skin. Thus, they are influencing only one component of the multifaceted and complex aging process of the face.
Retin-A is not the “fountain of youth” and will not reverse significant aging changes. Thus, it is not an alternative to surgery. While Retin-A is by no means as effective as a chemical peel nor a replacement for facial cosmetic surgery, it does in fact have a role in improving the early skin changes associated with aging the formation of fine wrinkles.