[PHNUTR-L] Vitamin A (Retinol) Effaces Wrinkles in Naturally Aged
fivestar at nutritionucanlivewith.com
Wed Jun 6 12:06:08 PDT 2007
Colleagues, the following is FYI and does not necessarily reflect my own
opinion. I have no further knowledge of the topic. If you do not wish to
receive these posts, set your email filter to filter out any messages
coming from @nutritionucanlivewith.com and the program will remove
anything coming from me.
Vitamin A (Retinol) Effaces Wrinkles in Naturally Aged Skin
News Author: Laurie Barclay, MD
May 29, 2007 — Topical vitamin A (retinol) effaces fine wrinkles
associated with natural aging, according to the results of a small
randomized trial in elderly patients published in the May issue of the
Archives of Dermatology.
"Because accelerated skin aging due to excessive sun exposure has marked
collagen deficiency and effective treatments for photoaging promote
procollagen synthesis, we hypothesized that similar therapies might also
improve the collagen deficiency found in intrinsic aging," write Reza
Kafi, MD, from the University of Michigan Medical School in Ann Arbor,
and colleagues. "Compared with retinoic acid, the ability of retinol to
induce skin irritation is notably less, at least according to a 4-day
patch test (an occlusive treatment). Thus, retinol has the potential to
deliver retinoic acid–like effects to human skin with improved
In this double-blind, vehicle-controlled, left-and-right-arm comparison
study at an academic referral center, 36 elderly participants received
topical 0.4% retinol lotion or its vehicle applied at each visit by
study personnel to either the right or the left arm, as often as 3 times
weekly for 24 weeks. Mean age was 87 years, and all patients lived in 1
of 2 senior citizen facilities.
Primary endpoints were clinical assessment using a semiquantitative
scale (0, none; 9, most severe) and biochemical measurements from skin
biopsy specimens obtained from treated areas. Analysis was by
intent-to-treat, using the last-observation-carried-forward method.
After 24 weeks, changes in fine wrinkling scores were different between
retinol-treated and vehicle-treated skin (-1.64 [95% confidence interval
[CI], -2.06 to -1.22] vs -0.08 [95% CI, -0.17 to 0.01]; P < .001). In a
subgroup, retinol treatment was associated with increased
glycosaminoglycan expression (P = .02 [n = 6]) and procollagen I
immunostaining (P = .049 [n = 4]) compared with vehicle.
The retinol preparation was relatively well tolerated.
"Topical retinol improves fine wrinkles associated with natural aging,"
the authors write. "Significant induction of glycosaminoglycan, which is
known to retain substantial water, and increased collagen production are
most likely responsible for wrinkle effacement. With greater skin matrix
synthesis, retinol-treated aged skin is more likely to withstand skin
injury and ulcer formation along with improved appearance."
The Babcock Endowment for Dermatologic Research, the Merck-American
Federation for Aging Research, Alpha Omega Alpha Student Research
Fellowship, and the National Institutes of Health supported this study.
Four of the authors have disclosed being named inventors on an issued
patent application concerning methods of treating skin aging, and they
will receive royalties under the University of Michigan's Intellectual
Property Policy in the event that a commercial license is signed and a
product is sold.
Arch Dermatol. 2007;143:606-612.
The skin undergoes profound changes as adults grow older. These changes
are most noticeable in sun-exposed areas, but other unexposed areas
change as well. Generally, skin grows thinner and more finely wrinkled
with time. The epidermis and dermis become thinner, and the number of
keratinocytes and fibroblasts declines. Collagen formation is therefore
decreased, and, moreover, there is a qualitative fragmentation of dermal
collagen fibers in the skin of older adults.
Retinoic acid can improve skin damaged by the sun, but it has not been
extensively tested in skin that ages without sun exposure. The current
study addresses this subject.
* Patients eligible for study participation were 80 years or older,
in relatively good health, and free of skin diseases affecting the upper
extremity. Patients who had used topical medications within 2 weeks of
study entry or hormone therapy in the past 6 months were excluded from
* Study participants were randomized to receive topical 0.4%
retinol lotion or its vehicle as often as 3 times per week for 24 weeks.
Approximately 2 mL of either treatment were applied to the upper inner
arm for 24 weeks. Participants who complained of skin irritation had
their treatment held, and participants who had more than 2 weeks of
irritation were terminated from the study.
* Dermatologists blinded to study therapy assessed tactile
roughness, fine wrinkling, and overall severity of aging at 2, 4, 8, 16,
and 24 weeks after randomization. Participants also underwent skin
biopsies at baseline and 24 weeks to assess the effects of retinol
lotion on levels of glycosaminoglycans and procollagen I.
* 36 adults entered the study. Mean age was 87 years, and there
were more than twice as many women as men. 13 individuals dropped out of
the trial, with 3 of these dropouts resulting from adverse events
related to retinol lotion.
* Biopsy results indicated that retinol was active within the skin.
* Fine wrinkling improved with retinol treatment, whereas there was
little change in the control group. This benefit of retinol was evident
at 4 weeks of treatment and continued through week 24.
* Tactile roughness and overall severity were also improved with
retinol vs placebo.
* Retinol was associated with increased concentrations of
glycosaminoglycans and procollagen I in biopsy specimens at 24 weeks vs
* All patients in the retinol group had erythema at the application
site, and most also reported peeling, pruritus, and dryness. However,
most of these adverse events were classified as mild by patients.
* In a subgroup of patients who were followed up after the trial,
the clinical benefits of retinol therapy persisted to 12, but not 24,
weeks after treatment.
Pearls for Practice
* As skin ages, the epidermis and dermis become thinner, and the
number of keratinocytes and fibroblasts declines. Collagen formation is
therefore decreased, and there is a qualitative fragmentation of dermal
collagen fibers in the skin.
* The current study demonstrates that topical retinol can improve
the degree of fine wrinkling, tactile roughness, and overall severity of
changes in naturally aged skin unexposed to sunlight among older adults.
This effect was probably mediated by increased concentrations of
glycosaminoglycans and procollagen I induced by retinol treatment.
Kathrynne Holden, MS, RD < fivestar at nutritionucanlivewith.com >
"Ask the Parkinson Dietitian" http://www.parkinson.org/
"Eat well, stay well with Parkinson's disease"
"Parkinson's disease: Guidelines for Medical Nutrition Therapy"
More information about the PHNUTR-L