This article addresses the latest literature review on drugs that have been documented to improve the health and appearance of aged or photodamaged skin.(1, pdf)
By far the best preventive skin application comprises of sunscreens, but if the skin has already aged, then the consumer will be confronted with a bewildering array of beauty products claimed to combat skin aging, most unproven. Here is a list of drugs that work.
Idebenone
Idebenone is an antioxidant that may be prescribed in 0.5% and 1.0% strengths. A few weeks of application result in improvement in how rough/dry the skin is, fine lines and wrinkles, and skin hydration (intrinsic moisture in the skin), as shown in Fig. 1.
Fig 1. The improvement after 6 weeks of twice-daily application is similar with both strengths, but the shortcoming is that the study did not have controls, i.e., follow-up on participants who received a placebo. McDaniel DH, et al. J Cosmet Dermatol. 2005;4:167-173.
Copper Zinc Malonate
The following image shows the results of application of 0.25g of the product, twice daily, around the eyes, for 8 weeks.
Fig 2. Copper Zinc Malonate application reduces wrinkles and improves skin elasticity and skin hydration. Mille TF, Batra RS, Ramirez J. Poster presented at: American Academy of Dermatology 65th Annual Meeting; Feb. 2-6, 2007; Washington, DC.
Tretinoin or stabilized retinol product in conjunction with hydroquinone
Aged skin has a tendency to become spotty or mottled. Hydroquinones suppress pigment production and can take care of the spots, but they tend to cause skin reddening, scaling, burning and stinging. Vitamin A derivates such as tretinoin and retinol have proven benefits with respect to wrinkles.
The following study compared the outcomes resulting from 4 regimens after 12 weeks and 24 weeks. The drugs were 0.1% tretinoin, 4% hydroquinone, cleanser and moisturizer. The applications were twice daily. When tretinoin and hydroquinone were combined, hydroquinone was applied twice daily and tretinoin once daily, and when tretinoin and hydroquinone were used independently, then the application of these drugs was once daily and the second application comprised of cleanser and moisturizer. In the graph below, perioral means around mouth, periocular means around eyes, laxity refers to looseness and sallowness refers to yellowish tone.
Fig 3. Improvement of skin variables after 12 weeks and 24 weeks of topical application of various drug combinations. The asterisks imply that the results are significantly different from the other outcomes. Cosmetic Dermatology. 2006;19(4):255-261.
Tretinoin may irritate the skin, and hence 0.3% stabilized retinol may be used instead.
So these are the proven drugs that help. They can be described as cosmeceuticals since they combine the therapeutic properties of pharmaceuticals and the aesthetic improvement resulting from cosmetics. The article mentions some other potentially promising topical applications based on Vitamin C, Vitamin E and green tea extracts (antioxidants). But the reader is advised to stick to proven therapies.
References
- Bruce, S., Cosmeceuticals for the attenuation of extrinsic and intrinsic dermal aging, J Drugs Dermatol, 7, s17 (2008).