Second:
That there is no one topical agent has so great effects on the aging skin as a combination of 2 or 3 of them.
So basically, using Azaleic Acid in the morning (10-20% conc.) or Phytic Acid (4% concentration) and/or Vit. C (L-Ascorbic Acid 10-25% conc.) + Sunscreen.
Evening: 0,05-0,1% Tretinoin (1 inch) mixed with Azaleic Acid (1/2 inch), no moisturizer used at least 1 hour after treatment. You'll see great benefits from 6-12 weeks depending on the greatness of photo damage. The more damage one has the more pronounced the effects will be.
Eva Victoria, why do you use Azelaic acid and not Glycolic acid ? Does Azelaic acid function as a anti-inflammatory ?
I am unaware of any studies using Azelaic acid to treat photodamage. If there are any, could you please list them ?
From what I can find it is useful for treating melasma, which has more to do with the interaction of female hormones and sunlight, than photodamage.
Thank you Hoon for posting the links!
Azelaic Acid is a very potent anti-oxidant naturally occurring in plants (f. ex.barley).
Why I recommend it against photo damage is that it can be used as a vehicle to transport Tretinoin deeper in the skin layers hence enhance its effect.
Secondly, it does exfoliates the skin which will also make that other drugs will have an easier way to penetrate the skin hence have greater effect faster.
Azaleic Acid is a strong anti-inflammatory which can also help reduce dermatitis from prolonged Tretinoin use.
The usage of Azaleic Acid is very controversial among dermatologists however a few do recommend it for the treatment of photo aging together with other agents like Tretinoin. Remember that Tretinoin and also Azelaic Acid are approved only as drugs for the treatment of Acne (none of them are approved as the treatment of photo aging but they are still used for this as the only topical agents available against photo aging today).
I personally have used 20% Azaleic Acid mixed with 10% Glycolic Acid (have seen it lately as used for treatment og melasma also by derms.) for a long time. I also add 10% L-Ascorbic-Acid to the mixture and store it in the fridge.
Have some clients who have used this mixture Am and Tretinoin 0,05% mixed with 20% Azaleic Acid Pm with great success when it comes to minimizing, sluggish skin, wrinkles, melasma. Generally their skin looked younger, fresher, more even skin tone and less lined. These changes were visible after approx. 6 weeks but for some it took as long as 24 weeks. Many of them still tell me after 2 years of use that they still see improvement in their skin. (These are women of age 45-60 with considerable photo damage).
Here is a link to several articles/studies about the effect of Azaleic Acid.
http://search.medsca...xt=azelaic acidI found an other prersentation an Medscape the other day and you and your thread about Facial rejouvenation spring in my mind:
http://www.medscape....rticle/488415_1It says among others about facial rejouv. that there are 3 types:
1.Medical Rejouvenation:Anti-oxidants, retinoids, Growth-factors, AHAs.
2.Procedural rejouvenation:Resurfacing, Fillers, Botox, Volumetric treatments, Thermage.
3.Surgical rejouvenation:
Liposuction, Blepharoplasty, Rhytidectomy, Implants.
http://www.medscape....rticle/488415_4Here is the table of Off-label use of Topical Retinoids. This is from the link Ben-Aus kindly provided us with! I enclose the article from Medsacape in .doc so every body can have the pleasure to read it. (Tretinoin Therapy.doc)
Table 2. Indicated vs. Off-Label Use of Topical Retinoids Indicated uses Acne Vulgaris
- Tretinoin (Retin-A®, Retin-A Micro®, Avita®)
- Adapalene (Differin®)
- Tazorotene gel or cream (Tazorac®)
Adjunct to Comprehensive Skin Care and Sunlight Avoidance Programs in the Palliation of Fine Wrinkles, Mottled Hyperpigmentation, and Tactile Roughness of Facial Skin
Plaque Psoriasis
- Tazarotene gel or cream (Tazorac®)
An Adjunctive Agent for the Use in the Mitigation (Palliation) of Fine Wrinkling, Facial Mottled Hyper and Hypopigmentation, and Benign Facial Lentigines in Patients Who Use Comprehensive Skin Care and Sunlight Avoidance Programs
- Tazarotene cream (Avage®)
Off-Label uses Photoaging/Intrinsic aging
Actinic keratoses/Actinic lentigines
Pre-malignant oral lesions
Rosacea
Verruca
Hypertrophic scars/Keloids/Acne scars/Striae
Cutaneous lichen planus
Melasma
Darier's disease
Wound healing
Granular parakeratosis
Multiple miliary osteoma cutis
Alopecia areata
Nevus sebaceous
Acanthosis nigricans
Sources: Allergan (2002); NPPR (2003)
So as you can see there are different usage of topical agents than they are approved for by the FDA. And it is also valid for Azaleic Acid, Hydroquinone (approved for skin lightening but can be used successfully in the treatment of acne which it is not approved for).