Topical tretinoin precursors (TTP) do not appear to differ from tretinoin (RA) for treating moderate-to-severe facial photodamage, according to a study published online June 8 in JAMA Dermatology.

Anna L. Chien, M.D., from the Johns Hopkins School of Medicine in Baltimore, and colleagues conducted a randomized, double-blind study involving 24 patients with moderate-to-severe facial photodamage. Participants were randomly assigned to receive daily topical application of RA or TTP formulation, containing retinol, retinyl acetate, and retinyl palmitate, for 24 weeks. The analysis included 20 White women (nine randomly assigned to TTP and 11 randomly assigned to RA).

The researchers observed no significant difference in Griffiths photoaging scores at week 24 among those receiving TTP versus RA (median, 4 versus 5). TTP treatment was associated with erythema less frequently than RA (11 versus 64 percent). In a target gene analysis, significant CRABP2 mRNA induction was seen, confirming retinoic acid receptor signaling, but there were no significant changes seen in procollagen I or MMP1/3/9 mRNA in samples treated with TTP. However, TTP-treated samples had a significant reduction in MMP2 mRNA, and there was a strong association for changes in MMP2 with changes in fine wrinkles. Greater improvements were seen in patients with severe baseline wrinkles.

"These results highlight the potential role that MMP2 may play in mediating retinoid efficacy in photoaging," the authors write. "Larger studies with more diverse patients should be pursued to validate these findings in a broader population."

Several authors disclosed financial ties to the biopharmaceutical industry, including SkinMedica, which funded the study.

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