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← ACTIVESRECORD A-01FAMILY RETINOID

Tretinoin

All-trans-retinoic acid

ALSO — RETINOIC ACID, VITAMIN A ACID

The molecule the whole category is measured against, and the only one a regulator has approved for facial wrinkles. Its own label denies, in capitals, that it reverses photoageing.

THE TRIALLED STRENGTH, IN THE RANGE WE HAVE SEEN0.001% ——— 0.1%
0.05%

The marker is the strength the trials were actually run at. The bar is the span this register has recorded, approved and compounded together. Anything below the marker is a dose nobody has tested; anything above it is an assumption about a dose–response curve nobody has drawn.

IDENTITY & RATINGSA
INCIAll-trans-retinoic acid
FAMILYRetinoid
MOL. WEIGHT300.44 g/mol
REFERENCE CONC.0.05%
RANGE SEEN0.001 – 0.1%
STATUSPRESCRIPTION ONLY
ACTS ATDERMIS
ONSET8–24 WK
STABILITYPHOTOLABILE — DEGRADES IN LIGHT AND AIR
TRIALS ON FILE5
IRRITATION INDEX6 / 10
STRATUM CORNEUMEPIDERMIS▸ DERMIS

The shaded band is the depth this molecule is understood to reach. Anything below it is out of scope, whatever the label says.

01

Mechanism

EVIDENCE GRADE A

Binds the retinoic acid nuclear receptors directly, with no conversion step. Reduces cohesiveness of follicular epithelial cells and microcomedone formation, increases keratinocyte turnover, and over months increases procollagen deposition in the papillary dermis.

HOUSE NOTES

  • The trial range starts at 0.025%. This register has found it compounded at 0.001%, 0.006%, 0.01%, 0.015% and 0.018% — all below anything ever tested.
  • Concentration without a vehicle is not a specification. The same 0.05% in an alcohol gel and in a hyaluronate lotion are different products; one produced dryness in 4% of users.
  • Systemic absorption from a microsphere gel was measured at 1.41% with repeated daily use, with plasma levels indistinguishable from baseline.
  • Effects are lost within about 12 weeks of stopping. That is the honest version of a retention message.

MEASURED ENDPOINTS

Fine facial wrinkling, any improvement+21%
24 WKREF-01
EGSS success, acne+9.6%
12 WKREF-13
Total lesion count reduction+22%
12 WKREF-23
Fine wrinkling, Fitzpatrick IV–VI-14%
24 WKREF-02
Application-site dryness, lotion vehicle-3%
12 WKREF-14

SUPPORTING RECORDS

  • REF-01A

    Four multi-centre randomised trials, vehicle-controlled, on a comprehensive sun-avoidance programme

    N=559 · 24 WK · DOUBLE-BLIND

  • REF-13A

    Multicentre randomised, vehicle-controlled

    N=820 · 12 WK · DOUBLE-BLIND

  • REF-23B

    Randomised, vehicle-controlled

    N=143 · 12 WK · DOUBLE-BLIND

  • REF-02B

    Single-centre randomised controlled trial in darkly pigmented, mostly African-American subjects

    N=107 · 24 WK · NOT STATED

  • REF-14A

    Pooled safety analysis of two randomised, vehicle-controlled trials

    N=1550 · 12 WK · DOUBLE-BLIND

02

Layering

CONFLICTS & PAIRINGS
DO NOT LAYER
  • Benzoyl peroxide (same application)
  • Glycolic acid (same night)
  • Pregnancy
PAIRS WITH
03

Reviewed in

8 REVIEWS
EVERY FIGURE HERE RESOLVES TO A RECORD IN THE EVIDENCE REGISTER. NOT MEDICAL ADVICE.
PREVIOUS — A-20FluorouracilNEXT — A-02Tazarotene
THE DRAW · NO. 01

Win a year of
prescription skincare

One reader gets a 12 months CoreAge Rx derm plan — the compounded, physician-reviewed subscription we take apart in the register. Worth $780. Leave an address and you are entered.

PRIZE
12 MONTHS OF COREAGE RX
VALUE
$780 — $64.99/MO × 12
ENTRY
ONE EMAIL ADDRESS

VALUE IS THE PUBLISHED $64.99/MONTH SUBSCRIPTION PRICE OVER TWELVE MONTHS, AS RECORDED IN R-10. NO PURCHASE NECESSARY. WE REVIEW COREAGE RX — WE DO NOT SELL IT.

DEPTH 000%
THE DRAW · ONE READER

Win a year of
prescription skincare

One reader gets a 12 months CoreAge Rx derm subscription — compounded, physician-reviewed, delivered. The plan we score in the register.

VALUE$780
TERM12 MONTHS$64.99/MO × 12

VALUE IS THE PUBLISHED $64.99/MONTH SUBSCRIPTION PRICE OVER TWELVE MONTHS, AS RECORDED IN R-10. NO PURCHASE NECESSARY. WE REVIEW COREAGE RX — WE DO NOT SELL IT.