RT Book, Section A1 Baumann, Leslie S. A2 Baumann, Leslie S. A2 Rieder, Evan A. A2 Sun, Mary D. SR Print(0) ID 1197536536 T1 Retinoids T2 Baumann’s Cosmetic Dermatology, 3e YR 2022 FD 2022 PB McGraw Hill LLC PP New York, NY SN 9780071794190 LK dermatology.mhmedical.com/content.aspx?aid=1197536536 RD 2024/03/28 AB SUMMARY POINTSWhat’s Important?UVB exposure and free radicals cause a decrease in collagen production by blocking the TGF-β/SMAD pathway and an increase in breakdown of collagen by increasing matrix metalloproteinases (MMPs). Retinoids block both of these pathways, leading to increased collagen in the skin.Retinoids are the most proven of any anti-aging ingredients and are FDA approved for photoaging.Retinoids improve extrinsically and intrinsically aged skin.Retinol turns into all-trans retinoic acid inside the cell cytoplasm.Scaling and peeling occur within 2 to 4 days of beginning topical treatment.Pretreating skin with retinoids 2 weeks prior to a cosmetic procedure speeds wound healing.Retinoids can, and should, be used in patients who have excessive sun exposure along with antioxidants to protect skin from UV damage and MMPs.Retinoids are unstable when exposed to air, light, oxidizing agents, high temperature, and low pH.What’s New?Retinol has been proven in many studies to reduce fine lines and wrinkles.Retinoid dermatitis is mediated in part by epidermal derived growth factor.Genistein can be used to block epidermal-derived growth factor and reduce peeling.What’s Coming?Combining retinoids with anti-aging ingredients as discussed in Chapter 37, Anti-Aging Ingredients.More stable formulations of retinols are in the pipeline.Retinoid/genistein products are being developed with technologies that promote penetration of genistein.Trifarotene has not yet been studied for the treatment of photoaged skin, but it is likely that it will demonstrate efficacy.