Tretinoin treatment before carbon-dioxide laser resurfacing: a clinical and biochemical analysis.
BACKGROUND
Tretinoin is often prescribed before laser resurfacing in an attempt to enhance results.


OBJECTIVE
We sought to assess the clinical and biochemical effects of preoperative tretinoin use before laser resurfacing.


METHODS
Patients were randomized to apply tretinoin to one forearm and placebo to the other for 3 weeks. Patients' photodamaged forearms were focally treated by carbon-dioxide laser resurfacing. Biopsy specimens were obtained at baseline and various times posttreatment. Real-time polymerase chain reaction technology was used to quantify messenger RNA levels of types I and III procollagen and matrix metalloproteinases-1, 3, and 9. Wounds were assessed for degree of re-epithelialization using a computer graphics-generated template. A colorimeter was used to quantify postoperative erythema.


RESULTS
No substantial differences in either biochemical markers or clinical end points were identified between tretinoin and placebo pretreated forearms.


CONCLUSIONS
We found no evidence of enhanced collagen formation, accelerated re-epithelialization, or quicker resolution of postoperative erythema with tretinoin pretreatment before laser resurfacing.
Orringer
Jeffrey S
JS
Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan 48109-0314, USA. jorringe@umich.edu
Kang
Sewon
S
Johnson
Timothy M
TM
Karimipour
Darius J
DJ
Hamilton
Ted
T
Hammerberg
Craig
C
Voorhees
John J
JJ
Fisher
Gary J
GJ
D000279:Administration, Cutaneous; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D004890:Erythema / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D007641:Keratolytic Agents / Q000627:therapeutic use*; D053685:Laser Therapy; D007834:Lasers / Q000009:adverse effects; D020782:Matrix Metalloproteinases / Q000096:biosynthesis / Q000235:genetics; D011347:Procollagen / Q000096:biosynthesis / Q000235:genetics; D011446:Prospective Studies; D012333:RNA, Messenger / Q000096:biosynthesis; D012867:Skin / Q000378:metabolism; D015595:Skin Aging / Q000187:drug effects* / Q000502:physiology / Q000528:radiation effects; D014212:Tretinoin / Q000627:therapeutic use*
D007641:Keratolytic Agents; D011347:Procollagen; D012333:RNA, Messenger; D014212:Tretinoin; D020782:Matrix Metalloproteinases