About the author: FutureDerm.com is proud to introduce John Su on our staff as a Contributing Writer. John is an established skin care expert and aspiring dermatologist. He also runs a blog, The Triple Helix Liaison, dedicated to providing unbiased, meaningful, and insightful information about skin care. For his full bio, please visit our About page.
Tretinoin is available in prescription Retin-A, Renova, Avita, Atilinac, and Atralin. It is also available in lesser concentrations in products like Obagi Refissa and RP Pharmaceuticals Tretinoin Cream, shown above.
Today’s article will be similarly limited to the discussion of tretinoin. Other retinoids like tazarotene and adapalene are quite structurally different and will be discussed in the future.
What is Tretinoin?
Tretinoin or all-trans retinoic acid is a lipid-soluble molecule that possesses an acidic component (specifically a carboxylic acid group) at one end and a lipid-soluble component (specifically a beta-ionone ring) at the other, with a long polyunsatured carbon chain linking the two.
Retinol or Vitamin A is simply the alcohol form of tretinoin that has yet to be enzymatically oxidized, meaning that it needs to lose electrons. Retinol must first be converted into retinal (aldehyde) and then ultimately tretinoin.
What Can Tretinoin Do For the Skin?
Before and after tretinoin, via Dr. Obagi. Note the improvement in fine lines, wrinkles, texture, and signs of acne.
Tretinoin is fantastic because it can address acne and photodamage, which is a rare quality. Tied with hydroxy acids, it is my most recommended ingredient because of this unique duality.
How Does Tretinoin Help with Acne?
Before and after tretinoin.
Tretinoin functions by reducing the positive and negative polarities of skin cells – think about reducing charge across a magnet! These skin cells are called keratinocytes. This decrease in charge allows for more even and normalized natural exfoliation.
Tretinoin also decreases the levels of transglutaminase, an enzyme that cross-links the trans-membrane proteins present on keratinocyte surfaces (1). Therefore, tretinoin is effective at loosening impactions (2); think mini blackheads and whiteheads.
Not to mention that tretinoin’s exfoliant properties allow for deeper penetration of other treatments such as salicylic acid and topical antibiotics. Together with these ingredients, acne breakouts are decreased both mutually and synergistically.
How Does Tretinoin Treat Photodamage?
This pretty molecule is collagen. Regular tretinoin use helps to prevent collagen loss. How? Tretinoin essentially gets rid of the enzymes that degrade collagen.
UV-induced damage results in dramatic decreases in collagen production, specifically collagen types I (makes up 80% of the dermis matrix), III (10%), and VII (1%) (3).
Furthermore, UV damage massively increases the production of several enzymes that break down collagen, called matrix metalloproteinases (4). These enzymes result in the production of collagenase, gelatinase, and stromelysin. Tretinoin inhibits the creation of all three of these collagen-degrading enzymes (5)!
For the Ultra Scientific
This happens because two transcription factors, c-Jun and c-Fos, combine to produce activator protein-1 (AP-1). In turn, this activates the MMP genes.
By inactivating one of the transcription factors, the MMPs never come into play – resulting in preserved collagen. Tretinoin specifically inactivates the c-Jun protein by stimulating its breakdown through a chemical pathway known as the ubiquitin-proteasome pathway.
Bottom Line
Women who are pregnant or nursing should not use tretinoin, as vitamin A toxicity has been shown to result in birth defects and to be harmful for infants. [Read more: FutureDerm - Skin Care Ingredients and Supplements Pregnant or Nursing Women Should Not Use]
Now, I know that this only beings to scratch the surface of what tretinoin, the most studied topical treatment used in dermatology, can do. But I hope it gives you all the appropriate mindset to better understand the upcoming retinol metabolism post! Stay tuned!
Links/References:
About Author
John Su describes himself as eccentric—you might find him having a conversation with himself. He’s a stickler for accuracy, so you might find him correcting one thing or another! His goal is to answer questions and provide unbiased, meaningful, and insightful information when it comes to skin care. His underlying motivations stem from a need to inform people who have doubts, questions, or even prayers for solutions to their problems. He has his own skin care blog, The Triple Helixian.
View all John Su posts.(12) Readers Comments
Leave A Reply
Leave a Reply
Vanessa
Hi. Is adapalene as effective as tretinoin for photodamage and acne?
Adriana
I was wondering the same about the adapaline. I have been using Epiduo (adapalene is one of the ingredients, benzoyl peroxide being the other), hence the interest.
Pingback: Spotlight On: Tretinoin-FutureDerm Post! v 0.09 « TheTripleHelixLiaison
John
@Vanessa and @Adriana
Unfortnately, adapalene does not have nearly as much research about treating photodamaged skin as tretinoin. This may be at least partially because adapelene was designed to only bind to RAR receptors, not RXR ones. Tretinoin binds to both. This may also be responsible for the fact that adapalene has been shown to be less irritating than tretinoin. Furthermore, Adapalene is excellent for acne-prone skin since it possesses great comedolytic properties, follicular penetration capabilities, and is anti-inflammatory; all great for treating acne breakouts.
And as you can see from the Epiduo gel, adalepene is the only retinoid that can be used in conjunction with benzoyl peroxide, because it is so stable. The replacement of the weak “polyunsaturated carbon chain” seen above with aromatic benzene rings, allows for significant increases in stability and resistance to the ROS (free radicals) generated by benzoyl peroxide. It’s so strong that not even sunlight can significantly break it down.
I hope that helped!
Arlene
Hi just stumbled across your blog–so helpful! Any thoughts on retinaldehyde products?
John
@Arlene
Thanks! I hope to see your comments on the blog!
Now unfortunately, it looks like there is a limited selection of products when it comes to retinal. It appears that Avene has a sort of monopoly on this ingredient. I’ve glanced at a few of the product ingredient lists, and they aren’t quite as elegant or diverse as I’d like. You’ll probably have more luck looking for a more tailored and higher concentrated retinol product than a retinal one.
Harriet
Hi John this is a bit of a specific question, apologies if you feel it is off topic! I was just wondering what your thoughts were on different Retin – A tretinoin products and whether some are better than others in dealing with cystic acne and also longterm aging benefits. I have heard of tazorac also but didnt know how this compared to renova, airol, etc. Thanks, and btw your blog is my new obsession
John Su
@Harriet
Well all Retin-A products utilize tretinoin. The different forms just employ different vehicles for varying skin types. For example the creams are more appropriate for dry skin types looking for anti-aging, while the gel forms are so for oily skin types looking for acne treatment. The Retin-A Micro form uses an encapsulated delivery system that releases tretinoin over time; it is less irritating that way. People typically use Micro if the regular version is too irritating. But it’s no worse or better since the active ingredient is the same.
As for Tazorac (drug name = tazarotene) and other synthetic retinoids like Differin (drug name = adapelene) they trigger different retinoid receptors in the skin when comapred to tretinoin. Check out this post for more information on tretinoin metabolism:
http://www.futurederm.com/2012/06/28/how-do-retinoids-work/
azarotene tend to act more quickly than Retin-A, as it’s more “targeted,” in terms of anti-aging. However, the longterm effects appear to be the same. Adapalene on the other hand, has limited documentation showing anti-aging effects; it’s better suited for acne treatment. I’d say any prescription retinoid will work, and if you can get your hands on one, go for it!
Also, note that a lot of prescription products these days contain a retinoid along with other active ingredients such as hydroquinone and others. So keep that in mind.
Thanks for checking out my blog! I hope to see more comments from you there. And I wish I had more content for you guys. I definitely need to step up to the plate!
Matheus F.
I had used conventional tretinoin, and now I’m using Retin-A Micro.
The difference is amazing, my skin is MUCH better with Retin-A Micro…
Furthermore, I’m using SkinCeuticals Blemish+Age Defense (a perfect combination of 2% Dioic acid, 0,3% LHA, 1,5% Salicylic acid, 3,5 Glycolic acid and 0,5% Citric acid) in the morning, under my zinc oxide sunscreen.
PS: you should talk about dioic acid!
Really, If you guys can tolerate it, you should try, my skin has NEVER been so gorgeous.
But If I use regular tretinoin, the results aren’t so good and I start flaking.
The next step is put Serum 10 in the routine…
Thanks!
John Su
@Matheus F.
Good to hear that the Micro version is working for you! The time-release tretinoin does make it much less irritating!
If you’d like to use the Skinceuticals Blemish Defense (which contains more alcohol than water) I’d recommend using it at nighttime since it doesn’t have any notable photoprotective ingredient; only ones that may be potentially photosensitizing, vernacularly-speaking. I may do a post on dioic acid, but there really isn’t much to discuss since so few studies document its efficacy or mechanism of action.
Keep up the routine!
Matheus F.
Thanks John.
Talking about the possible photosensitizing effect, I don’t get lots of sun. So I think it’s not a problem.
But let me ask you, what about the computer’s light and tretinoin?
People (like Dr. Cynthia Bailey) say light degrades tretinoin, but I think they’re talking about sunlight, right?
Because before bedtime (and after applied Retin-A) I use to take a look on internet.
Thank you dear!
John Su
@Matheus F.
No, if any ultraviolet light even emits from your computer screen, the amount is most likely negligible. You’ll be fine using Retin-A and then going on the computer! It’s nothing to worry about.