Comparing Tretinoin to Other Topical Therapies in the Treatment of Skin Photoaging: A Systematic Review

IF 8.6 1区 医学 Q1 DERMATOLOGY
Zoya Siddiqui, Alina Zufall, Marissa Nash, Divya Rao, Rahim Hirani, Marian Russo
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引用次数: 0

Abstract

Background

Many morphological and histological changes take place in aging skin. Topical tretinoin is the gold standard anti-aging agent used to reduce signs of aging through stimulation of epidermal growth and differentiation and inhibition of collagenase.

Objective

The aim of this systematic review is to summarize studies evaluating the efficacy of tretinoin compared with other topical medications and cosmeceuticals in reducing the appearance of skin aging.

Methods

A systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. The literature search was conducted using the PubMed and Embase databases from conception to December 2023. Studies were included if they compared anti-aging outcomes of topical medications with those of topical tretinoin (also called all-trans retinoic acid and retinoic acid). Studies were excluded if they compared non-topical anti-aging treatments with tretinoin or were conducted on animal models.

Results

The literature search resulted in 25 studies that met all inclusion and exclusion criteria. The most common study comparators to tretinoin included other forms of vitamin A. Outcomes were reported on the basis of visual reduction of aging signs, histological assessment of the epidermis and dermis, and protein expression. Although comparators to tretinoin had variable efficacy (greater in 7 studies, equivalent in 13 studies, and less in 3 studies), most studies found the comparator to be less irritating and better tolerated by patients than tretinoin.

Discussion

Tretinoin is currently the gold standard therapy for the treatment of photoaging, but its poor tolerability often limits its use. Unfortunately, given that most studies comparing topical therapies with tretinoin are of poor quality and/or demonstrate bias, there is a lack of substantial evidence to support an alternative first-line therapy. However, given there are some data to support the efficacy of retinoid precursors, namely retinaldehyde, pro-retinal nanoparticles, and conjugated alpha-hydroxy acid and retinoid (AHA-ret), these agents can be considered a second-line option for anti-aging treatment in patients who cannot tolerate tretinoin.

比较曲安奈德与其他治疗皮肤光老化的外用疗法:系统回顾
背景:衰老的皮肤会发生许多形态学和组织学上的变化。外用维A酸是抗衰老的金标准药物,通过刺激表皮生长和分化以及抑制胶原酶来减少衰老迹象:本系统综述旨在总结评估曲安奈德与其他外用药物和药妆品在减少皮肤老化外观方面的功效的研究:按照《系统综述和元分析首选报告项目》(PRISMA)指南进行了系统综述。文献检索通过 PubMed 和 Embase 数据库进行,检索期从概念期到 2023 年 12 月。如果研究比较了外用药物与外用维甲酸(也称为全反式维甲酸和维甲酸)的抗衰老效果,则纳入这些研究。将非外用抗衰老疗法与维A酸进行比较或在动物模型上进行比较的研究则排除在外:文献检索结果显示,有 25 项研究符合所有纳入和排除标准。最常见的与维A酸比较的研究包括其他形式的维生素A。研究结果根据衰老迹象的视觉减少、表皮和真皮的组织学评估以及蛋白质表达进行报告。尽管与维A酸相比,对比药物的疗效各不相同(7 项研究的疗效较好,13 项研究的疗效相当,3 项研究的疗效较差),但大多数研究发现,与维A酸相比,对比药物的刺激性较小,患者的耐受性较好:讨论:维甲酸是目前治疗光老化的金标准疗法,但其较差的耐受性往往限制了它的使用。遗憾的是,由于大多数将外用疗法与曲安奈德进行比较的研究质量不佳和/或存在偏差,因此缺乏大量证据来支持替代性一线疗法。不过,鉴于有一些数据支持视黄醇前体(即视黄醛、原视黄醇纳米颗粒和共轭α-羟基酸和视黄醇(AHA-ret))的疗效,这些药物可被视为不能耐受维A酸的患者进行抗衰老治疗的二线选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
15.20
自引率
2.70%
发文量
84
审稿时长
>12 weeks
期刊介绍: The American Journal of Clinical Dermatology is dedicated to evidence-based therapy and effective patient management in dermatology. It publishes critical review articles and clinically focused original research covering comprehensive aspects of dermatological conditions. The journal enhances visibility and educational value through features like Key Points summaries, plain language summaries, and various digital elements, ensuring accessibility and depth for a diverse readership.
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