Topical drug treatments for age spots

zoom

Tretinoin

One of the vitamin A-related compounds known as retinoids, topical tretinoin first received FDA approval in 1971 for treating acne. Since then, it has also been approved (at a concentration of 0.05%) for the reduction of wrinkles, roughness, and age spots.

Randomized placebo-controlled trials have consistently demonstrated that tretinoin improves photoaged skin.

Tissue studies indicate beneficial changes in collagen production and melanin distribution. Applied once a day at bedtime, tretinoin works by accelerating the turnover of skin cells and suppressing melanin-producing cells (melanocytes).

It can take several months to lighten age spots. Brand names include Retin-A, Retin-A Micro, Renova and Avita.

Possible side effects include irritation, redness, scaling, itchiness burning, and dryness, though these generally subside after a few weeks. The irritation may actually be beneficial, because it helps tretinoin to penetrate the dermis (the layer below the epidermis) and stimulate the production of new blood vessels, collagen, and elastic tissue.

A warning: tretinoin makes the skin more sun-sensitive, so if you use it, you must apply a high-SPF, broad-spectrum sunscreen before going outdoors.

Animal experiments have shown that oral tretinoin can harm a foetus. It's not known whether topical tretinoin has any effects on developing humans, but because of the potential risk, women should not use it during pregnancy or lactation, or if they are trying to conceive.

To help avoid side effects, be sure to tell your doctor if you're taking other skin medications, such as the oral psoriasis drug acitretin (also a retinoid) or oral tretinoin.

For overall improvement in photoaged skin, tretinoin and other retinoid drugs are a better choice than hydroquinone. But if you need to treat specific age spots, hydroquinone or the depigmenting agent mequinol (4-hydroxyanisole) are preferable.

In a pair of randomized trials involving 1,175 subjects, a combination of mequinol with tretinoin in a liquid preparation (brand-named Solagé) was found to be superior to either of the active ingredients alone, and to a placebo, for the treatment of age spots on the forearms and face.

Adapalene gel

This prescription drug is approved only for treating acne but sometimes is used off-label to improve photoaged skin. In one controlled trial involving 90 men and women, solar lentigines lightened more in patients using adapalene than in those using a placebo.

Other prescription topicals

Another topical agent, azelaic acid, inhibits tyrosinase, an enzyme involved in melanin production. Although more irritating to the skin than hydroquinone, it may be an alternative for people reluctant to use hydroquinone because of the possible cancer connection.

Both drugs are effective in treating a condition known as melasma that often develops during pregnancy - diffuse mottled pigmentation on the cheeks and forehead and around the eyes.

Because age spots are considered a cosmetic problem, health insurance may not cover the cost of topical prescription medications. A 45-gram tube of generic tretinoin sells for $50 to more than $80 and lasts up to three months; a one-month supply of generic hydroquinone (30 grams) costs about $50.

A 30-gram tube of Tri-Luma - a popular combination of hydroquinone and tretinoin, plus a steroid to reduce redness - costs more than $100. Although these prescription drugs seem expensive, they may actually cost less than some over-the-counter skin-improvement products.

With summer behind us, it may be a good time to start treating photoaged skin. But remember that after any treatment for age spots, you must unfailingly use sun block. If you don't, just 10 minutes of sun on a spring day can cause them to become dark again, reversing the months of effort it took to lighten them.

Print | Email | Discuss this article

| Share |

READERS' COMMENTS

Click here to post a comment

Add your Comment All posts are sent to the administrator for review and are published only after approval. ArabianBusiness.com reserves the right to remove any comment at any time for any reason. Please keep your responses appropriate and on topic. Arabian Business would like to point out that only comments relevant to the story will be published. Any containing personal insults or inappropriate language will not be approved.
Name *
Remember me on this computer
Email *	(Your email address will not be published)
City
Country
Subject *
Comment *
Notify me of further comments
Enter the words above *
Please click post only once - your comment will not be published immediately.

MORE FROM ARABIANBUSINESS.COM