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Reducing skin wrinkles with tretinoin (Retin A, Renova)
Retin A and Renova are the best known brands of tretinoin (a short for trans-retinoic acid), a substance related to but distinct from vitamin A. To be precise, tretinoin is a biologically active metabolite of vitamin A. Tretinoin produces multiple effects in the skin. It works by triggering molecular switches in skin cells called retinoid receptors. These switches affect many intracellular processes including cell growth and differentiation, synthesis of proteins (including collagen and elastin), sebum production, and possibly even the cell's lifespan clock (telomeres). Furthermore, tretinoin indirectly inhibits matrix metalloproteinases (MMP), the enzymes that break down collagen and elastin, the skin's key structural proteins. MMP become overactive as we age and contribute to wrinkles and sagging skin. Overall, the biochemical effects of tretinoin are numerous and only some are well researched.
Topical tretinoin is one of very few substances whose anti-aging effects on the skin have been documented in many well-designed studies of various duration. It was found to reduce fine wrinkles and skin roughness, increase epidermal thickness and stimulate deposition of collagen. Typical strength of topical tretinoin creams is 0.025 - 0.1 percent. Side-effects are not uncommon and include skin-irritation, dryness, peeling and sun sensitivity. With tretinoin, more is not necessarily better. Studies indicate that 0.025 percent tretinoin may be almost as effective as 0.05 or 0.1 percent, but with lower incidence of skin irritation. According to the studies, improvement on tretinoin may continue for up to a year of continued use.
The first tretinoin brand to appear on the market was Retin A, initially developed to treat acne and later adopted as an anti-wrinkle product. Later, other formulations were developed in an attempt to reduce skin irritation and other side-effects. Those included Renova (tretinoin in a highly emollient base to reduce dryness), Retin A Micro (slow-release tretinoin encapsulated in microscopic particles to reduce skin irritation) and others. At present, all topical tretinoin brands are sold by prescription. Users should watch out for the side-effects even with supposedly less irritating formulations. If persistent, the side-effects of tretinoin may lead to skin damage and accelerated aging, i.e. the result opposite to the goal of the treatment. Fortunately, the irritation and other side-effects can in most cases be avoided or minimized with proper care.
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