- Tretinoin creams may be dangerous to smokers
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free skin care · Fri Feb 13, 2009 4:04 pm

A rather disturbing scientific study has recently been published in the reputable journal "Archives of Dermatology". The study shows that patients treated in a hospital with 0.1 % tretinoin topically to prevent skin cancer had a higher risk of death than the persons not using tretinoin.

A total of 1131 elderly people took part in the study, with 2-6-year follow-up. The study was stopped 6 months earlier than planned because of excess mortality in the treatment group. At the time the study was stopped, 108 deaths had occured among the 565 subjects in the tretinoin group, compared with 76 deaths among the 566 subjects in the control group.

Professor in Dermatology, Dr Leslie Baumann, called the results of the study "very disturbing" in her blog (see link below) recently.

Anti-Wrinkle Creams May Increase the Risk of Death

Quote:

Retin-A (generically known as tretinoin) is a vitamin A analogue that is a popular acne medication. It is also used "off-label" to prevent skin cancers, treat wrinkles and prevent skin aging. Renova, which is also a form of tretinoin, is FDA-approved to reduce the signs of wrinkles.

These products have been used safely and effectively for many years. However, a recent study by Weinstock published in the reputable journal Archives of Dermatology, was very disturbing. It showed that patients treated in a VA hospital with 0.1 % tretinoin topically to prevent skin cancer had a higher risk of death than those not using tretinoin. The veterans in this study were predominately elderly men

The researchers looked at various factors in the study to try to determine the explanation for the increased number of deaths among tretinoin users. It is difficult to know for sure because the study was not designed to look for risk of death, but it seems that it is smokers who are at greater risk.

This finding goes along with a study looking at an oral form of vitamin A called isotretinoin that showed that isotretinoin may be harmful to current smokers.

It is important to realize that this is the first sign of a risk of harm from using tretinoin after decades on the market, so this study's results may not hold up when more testing is done.

However, it is prudent to take this advice: If you use tretinoin (retinol, adapalene, tazarotene) or take vitamin A or beta carotene supplements, please don't smoke. Smoking is known to age your skin prematurely and to cause lung disease and heart disease. It now looks as if using popular anti-aging products in addition to smoking may increase your risk of death.

To join a discussion on this topic, please visit my website.

http://health.yahoo.com/experts/skintype/14808/anti-wrinkle-creams-may-increase-the-risk-of-death/

If you open the link to Dr Baumann's post, there are links to other articles about the study and excerpts from the study.

There was also this article from Journal Watch - medicine that matters - where the author writes that a causal association between tretinoin therapy and increased mortality is unlikely:

http://dermatology.jwatch.org/cgi/content/full/2009/130/1

Bottom line: This study is not good news for retinoid users, but more research is needed before one can draw conclusions about mortality as a potential "side effect" from tretinoin therapy.

free skin care · Sat Feb 14, 2009 6:01 am

Of course, nearly anything can be toxic in huge dosages. Eat a box of salt at a sitting and you're probably dead. But the worrying thing about this study is that statistically significant higher rates of death occurred when patients were using Retin A at dosages and frequencies comparable to normal usage. This isn't a situation where a lab rat was force fed a huge amount of a chemical and got cancer; it was normal human subjects using the product topically. This isn't the case with artificial sweeteners, hydroquinone, etc., where animal studies have shown toxicity only when exposed to mega-dosage amounts. So it would seem that this study, particularly given its congruence with earlier studies showing higher rates of lung cancer death among those using Vitamin A oral supplements, is worth serious consideration.

I think what we are seeing and will possibly continue to see is that there can be a negative side to all of the amazing active skincare ingredients that we are using. On the plus side, we are the first generation that has had the benefit of skincare products that have scientifically shown efficacy in doing more than just moisturizing. But products that are powerful enough to cause real change in the skin may be powerful enough to have real side effects, too. Keep in mind that the studies that have been done on these products are looking for efficacy first (is there a decrease in lines and wrinkles?) and immediate side effects (is there irritation or skin damage?) No one has yet done full scale epidemiological studies to look at whether there are other long term health effects of topical skincare actives.

I'm not giving up retinoids myself at the moment, but I have decided not to ramp up the dosage that I currently use and will give consideration to reducing my exposure further. And I will definitely continue to keep an eye on this area of research.

free skin care · Sat Feb 14, 2009 8:38 am

flitcraft wrote:

I think what we are seeing and will possibly continue to see is that there can be a negative side to all of the amazing active skincare ingredients that we are using. On the plus side, we are the first generation that has had the benefit of skincare products that have scientifically shown efficacy in doing more than just moisturizing. But products that are powerful enough to cause real change in the skin may be powerful enough to have real side effects, too. Keep in mind that the studies that have been done on these products are looking for efficacy first (is there a decrease in lines and wrinkles?) and immediate side effects (is there irritation or skin damage?) No one has yet done full scale epidemiological studies to look at whether there are other long term health effects of topical skincare actives.

Very well said, and I totally agree. I always say we don't know what the effect any of this stuff we put our faces will have in the future. The skin care industry and ingredients are just too new to have any long-term studies done on the effects of skin care to our health. Everything we put on our skin is absorbed into the body.

free skin care · Fri Feb 27, 2009 11:10 am

bciw wrote:

I think is pretty dangerous if you are smoking and have retin a applied close to your mouth

No. It does not matter which areas you apply Retin-A. You can very well apply it on your lips a few times a week.

The point is that Retin-A gets absorbed into the blood stream, and the main ingredient retinoic acid may cause harm if you are a smoker.

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