Efficacy and safety of retinaldehyde 0.1% and 0.05% creams used to treat photoaged skin: A randomized double-blind controlled trial.

BACKGROUND: Although topical retinoic acid effectively restores photoaged skin, the associated irritation limits the utility of the material. Retinaldehyde (RAL) is the natural precursor of retinoic acid and can also be used to treat photoaged skin; the safety profile is good. AIMS: To evaluate the efficacy and safety of new anti-aging creams containing RAL at 0.1% and 0.05% used to treat photoaged skin. PATIENTS AND METHODS: We enrolled 40 female Korean volunteers who applied RAL 0.1% or RAL 0.05% creams twice daily for 3 months. Wrinkles on, and the textures of, both crow's feet were quantitatively assessed using the Antera 3D® system. Transepidermal water loss (TEWL), skin hydration, the melanin index, and skin brightness were also evaluated. Overall improvement was assessed using a five-point scale by both the patients and the dermatologists. RESULTS: The 3-month application improved overall photoaging in both RAL 0.1% (95%) and RAL 0.05% groups (95%). Both RAL 0.1% and RAL 0.05% afforded significant textural improvements (13.7% and 12.6%, respectively), reduced the TEWL (14.5%, 17.9%), and increased hydration (10.2%, 6.0%); however, no statistical differences were observed between two groups. Only RAL 0.1% significantly improved the melanin index (by 6.5%). CONCLUSIONS: Both RAL 0.1% and RAL 0.05% creams were well tolerated and improved skin hydration and texture. However, only RAL 0.1% cream improved the melanin index.

The efficacy of topical drugs in treatment of noninflammatory acne vulgaris.

Treatment of Acne Vulgaris still remains as an actual problem. The purpose of the research was to study the curing process and side effects of topical drugs - Diacneal and Skinoren in patients with non-inflammatory acne vulgaris. The results of the research has confirmed the swift and stable treating effect of both preparations, that expressed in decrease in number and size of comedonal and papulo-comedonal formations, actually without side effects. Thus, in spite of divergence of either chemical composition or mechanism of action, both, Diacneal and Skinoren, may be recommended as a very good choice for monotherapy of non-inflammatory acne vulgaris.

Eficacia y seguridad del retinaldehido y el Ácido retinoico tópico en el tratamiento del fotoenvejecimiento / Efficacy and safety of retinaldehyde and topical retinoic acid in the treatment of photoaging

El ácido retinoico tópico es eficaz para el tratamiento del fotoenvejecimiento. Sin embargo la irritación cutánea secundaria a su uso es un factor limitante del tratamiento. El retinaldehído es un precursor inmediato del ácido retinoico que posee actividad biológica en la piel, con menos efectos secundarios. Objetivo: comparar la eficacia y tolerancia del retinaldehido y el ácido retinoico tópicos en el tratamiento del fotoenvejecimiento, mediante perfil profilométrico y análisis clínico - fotográfico y determinar los efectos secundarios de estos medicamentos. Métodos: se incluyeron 126 mujeres colombianas (35 a 60 años), quienes no habían recibido tratamientos previos, no estaban embarazadas, ni lactando. En total 119 pacientes completaron las 24 semanas de seguimiento: a 61 pacientes se les aplicó retinaldehído y a 58, ácido retinoico. Se realizó un seguimiento clínico (que evaluó mejoría y tolerancia), en las semanas 4, 8, 16 y 20, y además se realizó profilometría del área de la pata de gallina y seguimiento fotográfico al ingreso y en la semana 24.

Topical retinoic acid has been effectively used to treat photo aging; nevertheless, cutaneous irritation as a side effect is a limiting factor for treatment. Retinaldehyde is an immediate precursor of retinoic acid that has biologic activity in the skin, with few side effects. The objective of this investigation was to compare efficacy and tolerability of topical retinoic acid and retinaldehyde in the treatment of photo aging, by means of profilometry and clinical-photographic analysis and to determine side effects from both medications. Methods: were included 160 colombian women (aged 35 to 60 years), who hadn't had previous treatments and weren't pregnant or breast feeding. A total of 119 patients completed 24 weeks of treatment. Of these, 61 used retinaldehyde and 58 retinoic acid. Clinical evaluation was carried out on weeks 4, 8, 16 and 20, and profilometry of the “crow's feet” area was done at the beginning and at week 24.

Efficacy and safety of 0.1% retinaldehyde/ 6% glycolic acid (diacneal) for mild to moderate acne vulgaris. A multicentre, double-blind, randomized, vehicle-controlled trial.

BACKGROUND: Retinaldehyde and glycolic acid are both efficient in acne. OBJECTIVE: To evaluate the efficacy and tolerability of a 0.1% retinaldehyde/6% glycolic acid combination (Diacneal) for mild to moderate acne vulgaris. METHODS: Overall physician and patient ratings of acne symptom severity and tolerance were performed at baseline, months 1, 2 and 3. RESULTS: Mean numbers of papules, pustules and comedones were significantly reduced from month 1 onwards. A significant advantage of Diacneal over vehicle was demonstrated on the percentages of patients with ongoing healing lesions at month 2, healing ancient lesions from month 1 and patients with 'important/very important' global improvement from month 2 (50.0 vs. 26.3%) confirmed by patients at month 3 (86.1 vs. 58.8%). Products were well tolerated; only 1 patient had to stop the treatment. CONCLUSIONS: Diacneal, a combination of 0.1% retinaldehyde/6% glycolic acid, is effective and well tolerated in mild to moderate acne vulgaris.

A retrospective study of the effect of long-term topical application of retinaldehyde (0.05%) on the development of actinic keratosis.

BACKGROUND: The role of topical retinoids on photocarcinogenesis is still unclear. Retinaldehyde is a natural metabolite of vitamin A used as a cosmetic product. Its effect on actinic keratoses has not been studied to date. OBJECTIVE: To study the incidence of actinic keratoses during long-term application of retinaldehyde in order to evaluate a possible chemoprophylactic effect. METHODS: We conducted a retrospective study on 61 patients who had applied retinaldehyde on photoexposed body areas for a period ranging from 6 to 142 months. We counted the total number of actinic keratoses and cutaneous tumors that appeared over the time of exposure to retinaldehyde. RESULTS: The epidemiological characteristics of actinic keratoses were not modified by the application of retinaldehyde. Irregular application as compared to regular application of retinaldehyde was not associated with a change in the risk of actinic keratoses, suggesting that continuous use is not associated per se with a higher risk of actinic keratoses. CONCLUSION: With the statistical power limitation of this study, retinaldehyde applied alone does not appear to have prophylactic effects on the development of actinic keratoses. The design adopted is feasible to study the safety of cosmetic products applied for a long period of time.

Tolerance profile of retinol, retinaldehyde and retinoic acid under maximized and long-term clinical conditions.

BACKGROUND: Topical retinoic acid (RA) causes irritation of the skin. To prevent this side effect, natural precursors of RA have been proposed. The aim of the present study was to compare the local tolerance profiles of retinol (ROL), retinaldehyde (RAL) and RA. METHODS: ROL, RAL and RA were studied using repeated insult patch tests for 14 days (n = 6). Similarly, RAL and RA were assessed in long-term clinical use for 44 weeks (n = 355). Clinical scoring on irritation, measurement of transepidermal water loss (barrier function) and laser Doppler blood flow perfusion units (irritation) were performed. RESULTS: Under maximized conditions, an equally low irritation potential for ROL and RAL and a more pronounced irritant effect with RA could be demonstrated clinically (p < 0.05 in the intergroup analysis). Furthermore, RAL and RA induced more scaling than ROL (p < 0.05), and ROL and RA tended to induce more burning/pruritus than RAL (nonsignificant). The TEWL values were low with ROL and high with RAL and RA (nonsignificant, intergroup analysis). The laser Doppler measurements confirmed pro-irritating effects of RA and the nonirritating effects of ROL and RAL (p = 0. 001, intergroup analysis). The long-term clinical study showed that the study population developed a high frequency of erythema (44% of the population), scaling (35%) and burning/pruritus (29%) with RA in the first 4 weeks of treatment, whereas these 3 parameters were significantly less frequent with RAL (p < 0.0001 in the intergroup analysis). CONCLUSION: The natural retinoids ROL and RAL do have a good tolerance profile, in contrast with the irritating potential of RA.

Tolerance of topical retinaldehyde in humans.

BACKGROUND: Retinaldehyde (RAL) has been used as a topical agent in many countries since 1994. AIM: To review current data on the tolerance of retinaldehyde and to report the results of a long-term pilot study. METHODS: Data from published and on-file studies have been compiled. Forty-five patients who had applied RAL on the face for 12-89 months were specifically examined for side-effects. RESULTS: Studies in humans demonstrated an excellent tolerance of topical RAL on human skin. It was much better tolerated than retinoic acid and could be used even on sensitive facial skin. It does not have phototoxic or photo-allergic properties. No side-effects were associated with long-term use. CONCLUSION: Current data indicate a good topical tolerance of RAL in humans.

Vitamin A induction of cleft palate.

Both retinoic acid and retinyl acetate, administered in high doses on days 13--15 of gestation, are capable of causing a 90 per cent incidence of cleft palate in Charles River rats. However, an attempt to develop as in vivo rabbit model system for the induction of clefts via hypervitaminosis A was unsuccessful. In the rat, the retinoic acid form of vitamin A is the more potent teratogen, inducing clefts at less than half the dose required to produce them with retinyl acetate. Histologic examination of fetal rat heads confirmed the biochemical evidence that retinoic acid is the more potent teratogen. Both forms of vitamin A prevented palatal shelf reorientation from occurring at the correct gestational age. The retinyl acetate treatment delayed the rotation for approximately 12 hours, the retinoic acid for at least 48 hours.