title: Facilitating facial retinization through barrier improvement.
abstract: The utility of topical tretinoin as a treatment for improving the appearance of photodamaged skin is limited by irritation that occurs during the early phases of facial retinization. The observed side effects are consistent with stratum corneum barrier compromise. This paired double-blinded study was conducted to determine if preconditioning the skin with a barrier-enhancing cosmetic facial moisturizer before beginning tretinoin therapy and continuing moisturizer application during therapy would mitigate these side effects. Women with facial photodamage were recruited and randomly assigned to apply one cosmetic moisturizer to one side of the face and the other cosmetic moisturizer to the other side of the face twice daily for 10 weeks. One moisturizer contained a mixture of vitamins (niacinamide, panthenol, and tocopheryl acetate) to enhance stratum corneum barrier function, and the other moisturizer contained similar moisturizing ingredients but no vitamins. Daily full-face treatment with tretinoin cream 0.025% commenced 2 weeks into the study. Subjects' facial skin condition was monitored via investigator assessments, instrumental measurements, and subject self-assessments. The results show that improving stratum corneum barrier function before beginning topical tretinoin therapy and continuing use of a barrier-enhancing cosmetic moisturizer during therapy facilitates the early phase of facial retinization and augments the treatment response.
authors.affiliation: Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA. zdraelos@northstate.net
authors.forename: Zoe Diana
authors.initials: ZD
authors.lastname: Draelos
authors.forename: Keith D
authors.initials: KD
authors.lastname: Ertel
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Berge
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004643:Emollients / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D004817:Epidermis / Q000187:drug effects; D005260:Female; D006801:Humans; D007641:Keratolytic Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D008875:Middle Aged; D009657:North Carolina; D009820:Ohio; D015595:Skin Aging / Q000187:drug effects*; D012871:Skin Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D013472:Sunlight / Q000009:adverse effects; D016896:Treatment Outcome; D014212:Tretinoin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D004643:Emollients; D007641:Keratolytic Agents; D014212:Tretinoin