Introduction

Nowadays, the quest for youth and beauty has become an important issue. Improvement of visible signs of aging such as wrinkles, lack of firmness, dilated skin pores, and mottled pigmentation has become a concern impacting the women's quality of life and representing an important reason for consulting a dermatologist.1

Tretinoin has been used in dermatology since the 1960s, and its potential in the treatment of skin aging has been reported in the 1980s by Kligman et al.2 Since then, tretinoin has become the gold standard in the treatment of photoaged skin.3, 4 Its clinical efficacy in the treatment of photoaging has been investigated and proven more than for any other treatment including any other retinoid.5, 6

However, its use is also associated with a certain number of adverse effects (pruritus, burning sensation, erythema, and desquamation) currently known as “retinoid reaction”. These effects are more common with tretinoin and tazarotene than with isotretinoin, adapalene, retinol, and retinaldehyde.5 In contrast to the irritancy potential of classical retinoid therapies, cosmetic and cosmeceutical antiwrinkle products are generally well tolerated by the skin and are pleasant to use.7 While there are only few published reports of direct comparative studies, it is generally presumed that such products do not have clinical efficacy comparable with that of prescription topical therapies such as tretinoin.7, 8

Products containing retinol have been used in cosmetics since 1984. Retinol rationale in the treatment of photoaging was proven when Kang et al. showed that application of all‐trans‐retinol on normal human skin induces epidermal thickening and enhances the expression of CRABP II and CRBP mRNAs and proteins, as does retinoic acid, while only showing minimal signs of erythema and irritation unlike tretinoin.9 Moreover, retinol was shown to produce considerably less transepidermal water loss, irritancy, erythema, and scaling than tretinoin and several clinical studies demonstrated its relative capacity in monotherapy to improve fine wrinkles or aged skin.10-12

LR2412 or tetra‐hydro‐jasmonic acid is a potent derivative of jasmonic acid involved in plant wound repair and tissue regeneration. LR2412 has shown in vitro and in vivo its efficacy in counteracting signs of skin aging.13, 14 Indeed, LR2412 enhances in vitro the deposit of hyaluronic acid (HA) in the basal and suprabasal layers of the epidermis. LR2412 stimulates the hyalurosome and increases HA Synthases 2 and 3 and CD44 (HA receptor) expression. Furthermore, LR2412 stimulates keratinocytes in the basal layer, and it increases the epidermis thickness. LR2412 also strengthens collagen IV, laminin‐5, and fibrillin at the dermal–epidermal junction.14 Clinical investigations on the appearance of crow's feet wrinkles conducted over 3 months of daily application demonstrated that LR2412 reduced facial wrinkles.14 LR2412 also reversed steroid‐induced atrophy.14 Moreover, LR2412 improves the mechanical properties of the skin and it increases the deposition of fibrillin‐rich microfibrils.

In addition to LR2412 2% and retinol 0.2%, the proprietary association also contains adenosine and HA. To date, skincare products containing retinol, adenosine, and hyaluronic acid (Retinol HA day and night, Vichy Laboratoires, France) have demonstrated their efficacy in optimizing the treatment outcome of type A botulinum toxin injections.15

The aim of this current study was to compare the efficacy, tolerance, and subject perception of a fixed proprietary combination (Retinol 0.2%/LR2412 2%) vs. tretinoin 0.025% cream in women used to rejuvenation procedures, with at least moderate photoaged facial skin.