Dr Kiticharoensak Ornrapee
an aesthetitian at Hertitude clinic in Bangkok, Thailand.
Title: A Review of the Efficacy and Safety of Retinoids in the Treatment of Ultraviolet Related Skin Conditions and Skin Ageing
Biography
Biography: Dr Kiticharoensak Ornrapee
Abstract
Retinoids refer to all natural and synthetic products having a structure or biological activitiessimilar to vitamin A, which helps to modulate the function of homeostasis, metabolism, epithelialgrowth and immune regulation as well as inflammation via retinoid receptors. Recently, there hasbeen a growing interest in retinoids in the management of UV-related skin conditions, includingskin cancer, solar ageing as well as dyspigmentation, which cause a huge dermatological andpsychological burden on patients. However, scientific evidence and a standard guideline of retinoidson these conditions are still limited. Skin cancer is caused by accumulative DNA damage by UVRalong with an impaired DNA repair mechanisms. Retinoids seem to have a chemopreventive effectby modulating the repair processes and programmed cell death. Acitretin appears to be effective inthe chemoprevention of SCC among OTRs but due to the side effects of systemic retinoids, theapplication should be limited to high-risk populations and the rebound effect may occur afterdiscontinuing medication. UVR also causes skin ageing that leads to a structural and functionaldeterioration of skin. Wrinkling, mottled hyperpigmentation and solar lentigo can be improved bylong-term use of topical retinoids, such as topical tretinoin an adapalene. The efficacy seems to becorrelated with the strength of retinoids along with their side effects, which can gradually subsideovertime. Thus, low concentration of retinoids along with an emollient as well as a sunscreenapplication should be introduced during the initiating period to avoid drug interruption ordiscontinuation. Due to several limitations of clinical studies, the efficacy of cosmeceutical productson skin ageing is still controversial. Besides, long-term use of topical tretinoin may improvemelasma but a treatment combination along with topical retinoids is suggested to yield asatisfactory result with minimal side effects.(OTR- Organ transplant recipient, SCC- Squamous cell carcinoma, UVR-Ultraviolet radiation)