Drug treatment of photoaged skin

Although the prevention of skin aging is a holy grail of the cosmetic and p harmaceutical industries, this venture may be misplaced. The predominant cl inical and biochemical features of aged skin are mostly attributable to pho toaging rather than chronology. For instance chronic sun exposure is the ma jor determinant of age spots (actinic lentigines) and wrinkles. Surgical approaches to the treatment of photoaging include face-lift, derma brasion, chemical peeling, collagen and botulinum toxin injections, and las er re-surfacing. These approaches all have benefit and improve the clinical features of facial photoaging. Drug or pharmaceutical prevention and treatment of photoaged skin is still in its infancy. The main pharmaceutical approach to prevention of photoagin g lies in the assiduous use of sunscreens. Recent evidence points to the im portance of ultraviolet A (UVA) radiation as well as ultraviolet B (WB) rad iation in the aetiology of photoaging and thus the need for sunscreens that block both UVB and UVA. Drug treatment of photoaged skin can be categorised as antioxidants, alpha- hydroxy acids and topical retinoids. Of these 3 approaches only topical ret inoids, particularly tretinoin (all-trans retinoic acid), have a well docum ented ability to repair photoaged skin at the clinical, histological and mo lecular level. Furthermore, the use of topical retinoids may actually preve nt photoaging. The current interest in pharmaceutical modulation of the pho toaging process has attracted considerable research into the mechanisms of photoaging and cutaneous aging. It is likely that treatment for, or prevent ion of, the chronological aging process may result from such research.