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January 22, 1988

Topical Tretinoin Improves Photoaged Skin: A Double-blind Vehicle-Controlled Study

Author Affiliations

From the Dermatopharmacology Unit, Department of Dermatology (Drs Weiss, Ellis, Headington, and Voorhees, and Ms Tincoff and Mr Hamilton) and Department of Pathology (Dr Headington), University of Michigan Medical Center, Ann Arbor.

From the Dermatopharmacology Unit, Department of Dermatology (Drs Weiss, Ellis, Headington, and Voorhees, and Ms Tincoff and Mr Hamilton) and Department of Pathology (Dr Headington), University of Michigan Medical Center, Ann Arbor.

JAMA. 1988;259(4):527-532. doi:10.1001/jama.1988.03720040019020

In a 16-week randomized, double-blind, vehicle-controlled study of topical tretinoin in the treatment of photoaging, all patients applied topical tretinoin to one forearm and vehicle cream to the other. Half of the patients received tretinoin to the face, and half received vehicle cream. All 30 patients who completed the study showed statistically significant improvement in photoaging on the tretinoin-treated forearms, but not on the vehicle-treated forearms. Fourteen of the 15 patients who received tretinoin to the face had improvement in photoaging, whereas none of the vehicle-treated patients' faces improved, a statistically significant difference in response between the two groups. Statistically significant histologic changes were seen in forearm skin treated with tretinoin, but not with vehicle cream. Side effects were limited to irritation of tretinoin-exposed skin.

(JAMA 1988;259:527-532)

Kligman LH, Kligman AM:  Photoaging , in Fitzpatrick TB, Eisen AZ, Wolff K, et al (eds):  Dermatology in General Medicine , ed 3. New York, McGraw-Hill International Book Co, 1986, pp 1470-1475.
Fenske NA, Lober CW:  Structural and functional changes of normal aging skin.  J Am Acad Dermatol 1986;15:571-585.Crossref
Montagna W, Carlisle K:  Structural changes in aging human skin.  J Invest Dermatol 1979;73: 47-53.Crossref
Shuster S, Black MM, McVitie E:  The influence of age and sex on skin thickness, skin collagen and density.  Br J Dermatol 1975;93:639-643.Crossref
Kligman LH, Kligman AM:  The nature of photoaging: Its prevention and repair.  Photodermatol 1986;3:215-227.
Gillman T, Penn J, Bronks D, et al:  Abnormal elastic fibers.  Arch Pathol Lab Med 1955;59: 733-749.
Smith JG, Davison EA, Sams WM, et al:  Alterations in human dermal connective tissue with age and chronic sun damage.  J Invest Dermatol 1962;39:347-350.Crossref
Sams WM, Smith JG:  The histochemistry of chronically sun-damaged skin.  J Invest Dermatol 1961;37:447-452.Crossref
Gilchrest BA:  Skin and Aging Processes . Boca Raton, Fla, CRC Press Inc, 1984, pp 97-98.
Kligman LH, Akin FJ, Kligman AM:  The contributions of UVA and UVB to connective tissue damage in hairless mice.  J Invest Dermatol 1985;84:272-276.Crossref
Kligman LH, Akin FJ, Kligman AM:  Prevention of ultraviolet damage to the dermis of hairless mice by sunscreens.  J Invest Dermatol 1982;78: 181-189.Crossref
Kligman LH:  Photoaging: Manifestations, prevention and treatment.  Dermatol Clin 1986;4: 517-528.
Kligman LH, Akin FJ, Kligman AM:  Sunscreens promote repair of ultraviolet radiation-induced dermal damage.  J Invest Dermatol 1983;81: 98-102.Crossref
Kligman LH, Duo CH, Kligman AM:  Topical retinoic acid enhances the repair of ultraviolet damaged dermal connective tissue.  Connect Tissue Res 1984;12:139-150.Crossref
Kligman LH:  Effects of all-trans-retinoic acid on the dermis of hairless mice.  J Am Acad Dermatol 1986;15:779-785.Crossref
Kligman AM, Grove GL, Hirose R, et al:  Topical tretinoin for photoaged skin.  J Am Acad Dermatol 1986;15:836-859.Crossref
Elias PM, Williams ML:  Retinoids, cancer and the skin.  Arch Dermatol 1981;117:160-180.Crossref
Ellis CN, Gold RC, Grekin RC, et al:  Etretinate therapy stimulates deposition of a mucus-like material in epidermis of patients with psoriasis.  J Am Acad Dermatol 1982;6:699-704.Crossref
Kanerva LO, Johansson E, Niemi K-M, et al:  Epidermodysplasia verruciformis: Clinical and light- and electron-microscopic observations during etretinate therapy.  Arch Dermatol Res 1985;278: 153-160.Crossref
Orfanos CE, Runne U:  Tissue changes in psoriatic plaques after oral administration of retinoid.  Dermatologica 1978;157( (suppl 1) ):19-25.Crossref
Piepkorn M, Fleckman P, Carney H, et al:  Glycosaminoglycan synthesis by proliferating and differentiated human keratinocytes in culture.  J Invest Dermatol 1987;88:215-219.Crossref
Siegenthaler G, Saurat JH, Morin C, et al:  Cellular retinol- and retinoic acid—binding proteins in the epidermis and dermis of normal human skin.  Br J Dermatol 1984;111:647-654.Crossref
Puhvel SM, Sakamoto M:  Cellular retinoic acid—binding proteins in human epidermis and sebaceous follicles.  J Invest Dermatol 1984;82: 79-84.Crossref
Chytil F:  Retinoic acid: Biochemistry and metabolism.  J Am Acad Dermatol 1986;15:741-747.Crossref
Sporn MB, Roberts AB:  Role of retinoids in differentiation and carcinogenesis.  Cancer Res 1983;43:3034-3040.
Elias PM:  Epidermal effects of retinoids: Supramolecular observations and clinical implications.  J Am Acad Dermatol 1986;15:797-809.Crossref
Oikarinen Al, Oikarinen H, Uitto J:  Demonstration of cellular retinoic acid binding protein in cultured human skin fibroblasts.  Br J Dermatol 1985;113:529-535.Crossref
Barranco VP, Olson RI, Everett MA:  Response of actinic keratoses to vitamin A acid.  Cutis 1970;6:681-685.
Bollag W, Ott F:  Retinoic acid: Topical treatment of senile or actinic keratoses and basal cell carcinomas.  Agents Actions 1970;1:1172-1175.Crossref
Schumacher A, Stuttgen G:  Vitamin A—Säure bei Hyperkeratosen, epithelialen Tumoren und Akne.  Dtsch Med Wochenschr 1971;40:1547-1551.Crossref
Robinson TA, Kligman AM:  Treatment of solar keratoses of extremities with retinoic acid and 5-fluorouracil.  Br J Dermatol 1975;92:703-706.Crossref
Epstein JH:  All-trans-retinoic acid and cutaneous cancers.  J Am Acad Dermatol 1986;15:772-778.Crossref
Bollag W:  Prophylaxis of chemically induced benign and malignant epithelial tumors by retinoic acid.  Eur J Cancer Clin Oncol 1972;8:689-693.
Model D:  Smoker's face: An underrated clinical sign?  Br Med J Clin Res 1985;291:1760-1762.Crossref
Daniell HW:  Smoker's wrinkles: A study in the epidemiology of 'crow's feet.'  Ann Intern Med 1971;75:873-880.Crossref
Ippen M, Ippen H:  Approaches to prophylaxis of skin aging.  J Soc Cosmetic Chemists 1965;16: 305-308.
Fritsch PO, Pohlin G, Langle V, et al:  Response of epidermal cell proliferation to orally administered aromatic retinoid.  J Invest Dermatol 1981;77: 287-291.Crossref
Pinkus H, Hunter R:  Biometric analysis of the effect of oral vitamin A on human epidermis.  J Invest Dermatol 1964;42:131-136.