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Evidence summaries

Interventions for Photodamaged Skin

Topical tretinoin improves the appearance of mild to moderate photodamage on the face and forearms in the short term. Tazarotene and isotretinoin may also benefit patients with moderate photodamage on the face. All these agents cause skin irritation. Level of evidence: "A"

A Cochrane review [Abstract] 1 [withdrawn from publication] included 30 studies with a total of 3 319 subjects. Eight trials showed that topical tretinoin cream, in concentrations of 0.02% or higher, was superior to placebo for participants with mild to severe photodamage on the face and forearms (although losses to follow-up were relatively high in most studies). Relative risk of improvement for 0.05% tretinoin cream, compared to placebo (three studies), at 24 weeks, was 1.73 (95% confidence interval 1.39 to 2.14). This effect was not seen for 0.001% topical tretinoin (one study) or 0.01% (three studies). A dose-response relationship was evident for both effectiveness and skin irritation.

Tazarotene (0.01% to 0.1%) and isotretinoin (0.1%) both showed significant improvement over placebo for moderate photodamage (one study each). Effectiveness of 0.05% tretinoin appears to be equivalent to the effects of 0.05% and 0.1% tazarotene.

There is limited evidence of benefit from topical ascorbic acid compared with placebo, and CO2 laser technique compared with dermabrasion.

    References

    • Samuel M, Brooke R, Hollis S et al. WITHDRAWN: Interventions for photodamaged skin. Cochrane Database Syst Rev 2015;(6):CD001782. [PubMed]

Primary/Secondary Keywords