Q&A On RETIN-A
1. What does Retin-A do for wrinkles?
Retin-A is the first and only medical treatment which has been scientifically proven to significantly improve wrinkles. People who were treated with Retin-A had fewer fine and coarse wrinkles. These studies were recently published n the Journal of the American Medical Association and the American Academy of Dermatology.
2. What is Retin-A?
Retin-A is the trade name for Ortho Pharmaceutical Corporation’s topical altransretinoic acid (or tratinoic). It requires a prescription and comes in various concentrations as a gel, cream and solution. A two month supply costs approximately $15. cheaper than many cosmetics.
3. What other effects can Retin-A have?
In addition to reducing wrinkles, Retin-A improves skin color, texture and tone, mottled pigmentation (like liver spots) scars and sallowness. It may also help to reverse actinic keratoses, a pre-skin cancer.
4. How long does it take to work?
Usually after about one month, patients begin to notice some smoothing of the skin. Most people notice improvement in color and wrinkles within two to six months. Retin-A will probably not reverse the deeper wrinkles.
5. Who should use Retin-A?
Most dermatologists agree that almost anyone above 30 years old could benefit from it. Women who are pregnant, as well as those “allergic” to the sun should not use the medication.
6. Which patients show the most improvement?
In my experience with hundreds of patients over the last two years, the most noticeable benefits are in older people. Clinical improvement is seen in their wrinkles, roughness and blotchy skin.
Younger patients in their 30’s and 40’s also found improvement, but it was less dramatic, perhaps since the skin was not damaged. Its continued use may help prevent wrinkles and keep skin younger looking for these patients.
7. How does Retin-A work?
One theory is that it causes the cells to rejuvenate at a faster than normal rate. For example, skin which may normally turn over every 24 days may, with Retin-A usage, speed up the process to ten days. On biopsies of the skin, it has been shown to increase the blood vessels and possible increase the thickness of the deeper skin (dermis) with new collagen information.
8. What are the dangers?
Most patients in one study using a higher concentration of this drug experienced dryness and irritation. I always start patients on the Retin-A cream in lower concentrations, often in even more dilute concentrations that is commercially available, so as to minimize any irritation. Patients are quite happy with the results. A sunscreen should be used since Retin-A makes skin more sensitive to the sun. Additional precautions are recommended and carefully reviewed with the patient.
9. Where can I buy it?
From a drugstore – but you must have prescription – preferably from your dermatologist. Dermatologists are most experienced, having used the drug safely for about 20 years in acne treatment. Your dermatologist will carefully titrate the medication to the individual patient.
10. Do you have to use it forever?
The answer to this is still not known but probably a maintenance regimen using the medication less frequently, perhaps 2-3 times per week would help keep the improvement.