Cosmetic retinoid use in photoaged skin: A review of the compounds, their use and mechanisms of action

The inevitable attrition of skin due to ultraviolet radiation, termed photoaging, can be partially restored by treatment with retinoid compounds. Photoaged skin in lightly pigmented individuals, clinically presents with the appearance of wrinkles, increased laxity, and hyper- and hypopigmentation. Underlying these visible signs of ageing are histological features such as epidermal thinning, dermal-epidermal junction flattening, solar elastosis and loss of the dermal fibrillin microfibrillar network, fibrillar collagen and glycosaminoglycans. Retinoid compounds are comprised of three main generations with the first generation (all-trans retinoic acid, retinol, retinaldehyde and retinyl esters) primarily used for the clinical and cosmetic treatment of photoaging, with varying degrees of efficacy, tolerance and stability. All-trans retinoic acid is considered the 'gold standard' for skin rejuvenation; however, it is a prescription-only product largely confined to clinical use. Therefore, retinoid derivatives are readily incorporated into cosmeceutical formulations. The literature reported in this review suggests that retinol, retinyl esters and retinaldehyde that are used in many cosmeceutical products, are efficacious, safe and well-tolerated. Once in the skin, retinoids utilize a complex signalling pathway that promotes remodelling of photoaged epidermis and dermis and leads to the improvement of the cutaneous signs of photoaging.

Efficacy and mechanism of retinyl palmitate against UVB-induced skin photoaging

Retinyl palmitate (RP) is a vitamin A derivative that has been widely used in anti-aging and skin treatment. The aim of this study is to investigate the effect of RP on UVB (Ultraviolet radiation B) induced photoaging and its potential mechanism. Immunofluorescence assay demonstrates that RP can reduce collagen degradation in skin cells by UVB radiation and reduce apoptosis of skin cells. Cell migration assay reveals that RP can increase cell migration rate, helping to repair skin damage and restore cell viability. Immunohistochemical assays indicate that RP can significantly reduce the expression of IL-6, IL-1β, TNF-α induced by UVB radiation. Moreover, metabolomics and transcriptomics results suggest that RP regulates several metabolic pathways and gene expression, particularly in inflammatory signaling pathways, collagen synthesis and apoptosis, exhibiting significant regulatory effects. Furthermore, network pharmacological analysis predicts that RP may affect UVB-induced photoaging by regulating multiple key proteins and signaling pathways. Overall, this study demonstrates that RP has significant anti-photoaging ability, acting through several pathways including inhibition of inflammatory response, promotion of collagen synthesis and inhibition of apoptosis. These results provide a scientific basis for the application of RP in skin anti-photoaging and therapy, enabling the potential usage of RP to skin care products.

The vitamin A ester retinyl propionate has a unique metabolic profile and higher retinoid-related bioactivity over retinol and retinyl palmitate in human skin models

Human skin is exposed daily to environmental stressors, which cause acute damage and inflammation. Over time, this leads to morphological and visual appearance changes associated with premature ageing. Topical vitamin A derivatives such as retinol (ROL), retinyl palmitate (RPalm) and retinyl propionate (RP) have been used to reverse these changes and improve the appearance of skin. This study investigated a stoichiometric comparison of these retinoids using in vitro and ex vivo skin models. Skin biopsies were treated topically to compare skin penetration and metabolism. Treated keratinocytes were evaluated for transcriptomics profiling and hyaluronic acid (HA) synthesis and treated 3D epidermal skin equivalents were stained for epidermal thickness, Ki67 and filaggrin. A retinoic acid receptor-alpha (RARα) reporter cell line was used to compare retinoid activation levels. Results from ex vivo skin found that RP and ROL have higher penetration levels compared with RPalm. RP is metabolized primarily into ROL in the viable epidermis and dermis whereas ROL is esterified into RPalm and metabolized into the inactive retinoid 14-hydroxy-4,14-retro-retinol (14-HRR). RP treatment yielded higher RARα activation and HA synthesis levels than ROL whereas RPalm had a null effect. In keratinocytes, RP and ROL stimulated similar gene expression patterns and pathway theme profiles. In conclusion, RP and ROL show a similar response directionality whereas RPalm response was inconsistent. Additionally, RP has a consistently higher magnitude of response compared with ROL or RPalm.

Continuous Wave Fractional CO2 Laser for the Treatment of Upper Eyelid Dermatochalasis and Periorbital Rejuvenation

Fractional continuous wave CO2 laser resurfacing is used to improve photodamage, wrinkles, and acne scarring by surface ablation and by using heat to activate natural collagen production and dermal remodeling. In this study, the author examined the efficacy and safety of nonincisional continuous wave fractional CO2 laser blepharoplasty in the upper lid. Standard lid measurements including marginal reflex distance, palpebral fissure, and upper lid crease were performed preoperatively and at 6 months by the surgeon. All patients underwent full facial MIXTO continuous wave CO2 laser treatment (MIXTO Slim Evolution 2; MIXTOLasering USA, San Ramon, CA), including resurfacing on the upper eyelid from lashes to brow. We evaluated results at 6 months after laser treatment and found that on average, after MIXTO continuous wave laser treatment, marginal reflex distance of the upper lid increased from baseline from 0.7 to 2.2 mm, palpebral fissures increased from 5.6 to 7.4 mm, the upper lid crease was unchanged at 5.7 mm as was the upper lid excursion at 14.7 mm compared with those before treatment. Patients reported postoperative erythema, edema, crusting, and oozing that resolved within 14 days. These data demonstrate the safety and efficacy of noninvasive continuous wave fractional CO2 laser in the treatment of mild and moderate upper eyelid dermatochalasis.

Photo-co-carcinogenesis of Topically Applied Retinyl Palmitate in SKH-1 Hairless Mice

Cosmetic products that contain retinyl palmitate are popular as antiaging skin treatments; however, recent studies suggest a risk for enhanced skin tumor development with topical retinyl palmitate applications and exposure to solar ultraviolet radiation (UVR). In this study, we investigated the potential of retinyl palmitate to enhance UVR-induced photo-co-carcinogenesis. Groups of 36 male and 36 female SKH-1 hairless mice were exposed to simulated solar light (SSL) and treated with the control cream or creams containing retinyl palmitate, 5 days per week for 40 weeks. Other groups of mice were exposed to SSL and received no cream treatment or received cream treatments and were exposed to ultraviolet-A or ultraviolet-B. Mice were monitored for the development of skin tumors, and the incidences and multiplicities of squamous cell neoplasia were determined by histopathology. In both the absence and presence of SSL, mice administered the control cream developed skin tumors earlier and had higher incidences and multiplicities of skin squamous cell neoplasms than mice that received no cream treatment. Compared to the control cream groups, mice exposed to SSL and administered the retinyl palmitate creams demonstrated earlier onsets of skin tumors and had increased incidences and multiplicities of squamous cell skin neoplasms.

A novel continuous colour mapping approach for visualization of facial skin hydration and transepidermal water loss for four ethnic groups

OBJECTIVES

The aim of this exploratory study was to develop a novel colour mapping approach to visualize and interpret the complexity of facial skin hydration and barrier properties of four ethnic groups (Caucasians, Indians, Chinese and Black Africans) living in Pretoria, South Africa.

METHODS

We measured transepidermal water loss (TEWL) and skin capacitance on 30 pre-defined sites on the forehead, cheek, jaw and eye areas of sixteen women (four per ethnic group) and took digital images of their faces. Continuous colour maps were generated by interpolating between each measured value and superimposing the values on the digital images.

RESULTS

The complexity of facial skin hydration and skin barrier properties is revealed by these measurements and visualized by the continuous colour maps of the digital images. Overall, the Caucasian subjects had the better barrier properties followed by the Black African subjects, Chinese subjects and Indian subjects. Nevertheless, the two more darkly pigmented ethnic groups had superior skin hydration properties. Subtle differences were seen when examining the different facial sites.

CONCLUSIONS

There exists remarkable skin capacitance and TEWL gradients within short distances on selected areas of the face. These gradients are distinctive in the different ethnic groups. In contrast to other reports, we found that darkly pigmented skin does not always have a superior barrier function and differences in skin hydration values are complex on the different parts of the face among the different ethnic groups.