• Protecting Yourself
  from the Sun
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Topical Vitamin A

In recent years, there has been considerable publicity regarding the use of topical preparations to decrease the wrinkles and splotchy pigmentation associated with sun damage. Vitamin A derivatives (e.g. Retin-A, Renova, Avage, and Tazorac) have been shown in clinical studies to significantly improve this “photoaging”.

Photoaging refers to the fine wrinkles, irregular pigmentation, and leathery appearance which affect skin that has been exposed to sunlight for many years. Photoaging is much more dramatic in those with fair skin. Because the effects of sunlight on skin are cumulative, it is never “too late” to get smart about sun exposure. We recommend “wide-spectrum” sunscreens that block both UVA and UVB, with a sun protective factor (SPF) of 15 or greater. Many cosmetics contain sunscreens but frequently have an SPF less than 15.

Tretinoin, which is marketed under the trade name Retin-A, is a Vitamin A derivative which has been safely and effectively used in the treatment of acne since 1971. It is particularly effective in decreasing whiteheads and blackheads.

Published studies demonstrate that Retin-A, and the newer Vitamin A derivatives, also reverse the effects of chronic sun damage: fine wrinkles, irregular pigmentation, leathery texture, loss of elasticity (tone), and possibly precancerous changes. With treatment, the skin develops a smoother texture and “rosy glow.”

Renova is a reformulated version of Retin-A. Both creams contain the same active ingredient (tretinoin), but Renova benefits from greater cosmetic elegance and less tendency to cause irritation. Renova is FDA-approved only for treatment of fine wrinkling. Because of this, insurance companies often refuse to pay for this helpful “cosmetic” product. Over-the-counter products labeled “Retinol” are not equivalent to Retin-A or Renova, so don’t be fooled!

Fortunately, the side effects of topical Vitamin A derivatives are usually minimal. Initially, most patients develop some mild irritation, with increased flaking and dryness, as the skin adjusts to the new medicine. Starting applications every third night for the first 2-3 weeks can diminish this irritation. As the skin develops tolerance, applications can often be increased to every other night for 2-3 weeks, and then nightly thereafter. It is normal to experience some stinging, burning, dryness, and maybe even a slight rash. Don’t worry - these disappear in almost all patients after a few weeks of use. About 1-5% of patients experience increased sun sensitivity with Retin-A and Renova, so it is again wise to apply a sunscreen every morning and limit excessive sun exposure while using these products.