Our ingredients Tretinoin

Tretinoin is a vitamin A derivative, used for the treatment of acne and to treat and prevent signs of ageing. It is known by the brand name Retin-A and has been used by millions of people worldwide since 1960.

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Grade Indication Size of effect Comments
A Wrinkle treatment Strong Improves fine and coarse wrinkles by restoring dermal collagen
A Acne treatment Strong Reduces comedones, papules and pustules, and is suitable for long term maintenance therapy
A Smoother Skin Strong Diminishes skin roughness
A Tighter skin Strong Tightens loose and sagging skin
B Skin lightening Moderate Decreases the darkness of brown spots by reducing epidermal pigmentation. Also improves sallow skin.
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the science of Tretinoin

Anti-ageing

Tretinoin has been investigated the most out of all the topical retinoids for clinical effectiveness and safety with over 20 randomised trials either comparing it to placebo or other treatments.[1] Evidence of its effectiveness first being demonstrated in the 1980’s. [2]

Certain genes, formed from sequences in our DNA, are sensitive to topical retinoids, which lead to changes in the function of the cell. They improve signs of ageing by, increasing cell division leading to increased thickness in the top layer of the skin (the epidermis), compaction of the outermost cells in the skin (stratum corneum) and production of glycosaminoglycans (complex chains of sugar molecules which attract water). [1][2]

Clinical trails looking at the effectiveness of tretinoin look at the various signs of ageing including fine wrinkles, course wrinkles, hyperpigmentation (brown marks), skin texture, laxity, and signs of ageing seen on skin samples under the microscope.

Three trials were published between 1988-1993 involving 55 patients between them all showed statistically significant improvements with short-term (1-4 months) tretinoin use. [2]

As the short term studies showed continued improvements over time, 5 6-month trials were performed between 1989 and 1992 including 1,199 patients in total. All of these trails showed significant improvement in signs of ageing, even after 6 months. [2]

Since the 6-month trails longer-term trials have been performed, and consequently long term maintenance regimes have been recommended. [1]

Melasma

There have been 2 American trials including over 80 patients comparing treatment with tretinoin to placebo. One of the trials showed a significant improvement of pigmentation with tretinoin, although the other trial did not report a significant difference with placebo. [3]

However tretinoin can be mixed with other ingredients to make it more effective in the treatment of melisma including bleaching agents such as hydroquinone and fluocinolone acetate, which is a topical steroid. A recent systematic review of clinical trials, which looked at 20 studies of 2125 participants, has concluded that triple therapy with tretinoin, hydroquinone and fluocinolone acetate is more effective than hydroquinone alone, or dual combinations of tretinoin or hydroquinone with fluocinolone acetate. [3]

Acne

Topical retinoids are recommended as a first line treatment option either on their own or in combination with other treatments for mild acne. They are also recommended as a first line treatment option for moderate and severe acne in combination with other treatments. [4]

Tretinoin as a single therapy has been found to be effective in clinical trials for comedonal acne (blackheads and whiteheads) and inflammatory acne (papules (small bumps), nodules (large bumps) and pustules). [5][6]

Tretinoin is especially good in treating comedonal acne, and is also recommended to treat all acne variants when combined with other ingredients.(4) For example the combination of tretinoin with clindamycin (an antibiotic) has been shown to be more effective than either tretinoin or clindamycin alone. [7][8]

Topical antibiotics alone have been shown to be effective in treating acne but are no longer recommended as single therapy due to concerns of resistance. They can however be safely given in combination with other ingredients such as tretinoin.

Older studies have shown adapalene (a different topical retinoid) may be better tolerated than tretinoin, however this is based on old formulations. Limitations of the existing studies makes direct comparison of the effectiveness of different topical retinoids difficult. [4]

References