Objectives: The aim is to discuss how retinoids contribute to anti-aging, share tips of how to best use them, and point out recommendations for their use for impending facial resurfacing procedures, including ablative and non-ablative lasers, dermabrasion, microdermabrasion and chemical peeling.
Introduction: Retinoids comprise vitamin A and its natural and synthetic derivatives. They are used as therapeuticals and anti-aging cosmeceuticals by modulating cellular differentiation and proliferation. Tretinoin is used as a priming agent before facial resurfacing to optimize success, reduce the risk of postinflammatory hyperpigmentation and accelerate epidermal healing. However, is pre-treatment with retinoids necessary before all resurfacing procedures? Regimens for tretinoin use differ among the different resurfacing procedures, in terms of the dose, length of application and time of discontinuation.
Materials / method: Pubmed was used as a search engine to review the literature for the following keywords: retinoids, tretinoin, retinoic acid, retinol, isotretinoin, adaptalene, anti-aging, skin aging, facial resurfacing, lasers, chemical peeling, microdermabrasion and dermabrasion. The relevant articles, studies and books published between 2000 and 2018 were carefully selected and analysed.
Results: For the best results, it is advisable to use retinoids at night, start with small amounts 2x/week and slowly increase the usage. It is important to concomitantly use moisturizers, apply sunscreen and anti-oxidants in the morning, and avoid waxing and laser hair removal. Among the resurfacing procedures, ablative lasers, dermabrasion and deep chemical peels require use of the highest tretinoin concentration (0.1%) for the longest duration (3 months). Microdermabrasion does not require tretinoin pre-treatment. Regimens for chemical peels are divided into 3 categories depending on the peel depth.
Conclusion: The appropriate use of retinoids within a healthy skin caring regimen results in optimal skin rejuvenation. It is highly recommended to use them prior to certain, but not all facial resurfacing procedures to obtain the best outcomes. However, they should be discontinued one day prior to any procedure and should not be started sooner than 3–4 weeks prior to facial resurfacing. The greater the depth of injury caused by the resurfacing procedure, the greater the benefit of pre-treatment with tretinoin. Here, the guidelines for the pre-operative use of tretinoin in facial resurfacing are shared.
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