Retinoids in the treatment of photoageing: A histological study of topical retinoid efficacy in black skin.

Poonam Halai, Orsolya Kiss, R Wang, A. L. Chien, S Kang, C O'Connor, M Bell, C. E. M. Griffiths, Rachel Watson, Abigail Langton

Research output: Contribution to journalArticlepeer-review

Abstract

Background Photoageing describes complex cutaneous changes that occur due to chronic exposure to solar ultraviolet radiation (UVR). The ‘gold standard’ for the treatment of photoaged white skin is all-trans retinoic acid (ATRA); however, cosmetic retinol (ROL) has also proven efficacious. Recent work has identified that black skin is susceptible to photoageing, characterised by disintegration of fibrillin-rich microfibrils (FRMs) at the dermal-epidermal junction (DEJ). However, the impact of topical retinoids for repair of black skin has not been well investigated.

Objectives To determine the potential of retinoids to repair photoaged black skin.

Methods An exploratory intervention study was performed using an in vivo, short-term patch-test protocol. Healthy but photoaged black volunteers (>45 years) were recruited to the study and participant extensor forearms were occluded with either 0.025% ATRA (n = 6; 4-day application due to irritancy) or ROL (12-day treatment protocol for a cosmetic) at concentrations of 0.3% (n = 6) or 1% (n = 6). Punch biopsies from occluded but untreated control sites and retinoid-treated sites were processed for histological analyses of epidermal characteristics, melanin distribution and dermal remodelling.

Results Treatment with ATRA and ROL induced significant acanthosis (all P < 0.001) accompanied by a significant increase in keratinocyte proliferation (Ki67; all P < 0.01), dispersal of epidermal melanin and restoration of the FRMs at the DEJ (all P < 0.01), compared to untreated control.

Conclusions This study confirms that topical ATRA has utility for the repair of photoaged black skin and that ROL induces comparable effects on epidermal and dermal remodelling, albeit over a longer timeframe. The effects of topical retinoids on black photoaged skin are similar to those reported for white photoaged skin and suggest conserved biology in relation to repair of UVR-induced damage. Further investigation of topical retinoid efficacy in daily use is warranted for black skin.
Original languageEnglish
JournalJournal of the European Academy of Dermatology and Venereology
Publication statusAccepted/In press - 15 Mar 2024

Keywords

  • Photoageing
  • Skin of Colour
  • Retinoids

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