Legitimate Anti-Wrinkle Cream Question

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FatKid

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Hello everyone,

I was wondering if anyone knows of any LEGITIMATE scientific studies that have been done by DERMOLOGISTS or other M.D.'s comparing the different anti-wrinkle creams available.

I want to be able to speak to patients with some authority and knowledge about what anti-wrinkle creams have been scientifically shown to be effective.

Also, would the product I prescribe be different based on gender/age?

Thank you in advance.

-FatKid
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Tretinoin (Retin-A) is the only product that has been rigorously studied (I believe it was a NEJM paper) demonstrating improvement in wrinkles and photoaging. It is scientifically plausible that other prescription retinoids (adapalene and tazarotene) are effective as well.

All other advertised products are bogus. If those companies had real clinical data demonstrating efficacy, you can bet they would publish it in legitimate journals.

Tell your patients to age gracefully, wear sunscreen, avoid tanning, eat right, exercise, and stop throwing their money away to combat normal aging.
 
Thank you for your reply.

It seems only the Vitamin-based A drugs have any legitimacy to them.

I have been asked several times by young women in their 20's who want to begin using anti-wrinkle cream prophylacticaly. Would you recommend that Vitamin-A or another cream for long-term use beginning in 20's?
 
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Retin-A is fine for women in their twenties. Since it also helps with acne (specifically the comedonal type) they will also benefit from topical vitamin A. The only caveat? Insurance companies stop paying for Retin-A (and every other topical vitamin a for that matter, ie. tazarotene and adapalene) after a certain age in their twenties. I do not recall offhand but it is somewhere in the mid-twenties. So if they want the cream, it is self pay. A 30 gm tube runs about 130.00 (haven't checked in a while), but will last up to four months. Hope that helps. Every one of my colleagues uses Retin-A or some other derivative. I truly believe it helps. The most important thing for young women, though, is daily sunscreen with broad spectrum coverage.
 
chitowndermie said:
Retin-A is fine for women in their twenties. Since it also helps with acne (specifically the comedonal type) they will also benefit from topical vitamin A. The only caveat? Insurance companies stop paying for Retin-A (and every other topical vitamin a for that matter, ie. tazarotene and adapalene) after a certain age in their twenties. I do not recall offhand but it is somewhere in the mid-twenties. So if they want the cream, it is self pay. A 30 gm tube runs about 130.00 (haven't checked in a while), but will last up to four months. Hope that helps. Every one of my colleagues uses Retin-A or some other derivative. I truly believe it helps. The most important thing for young women, though, is daily sunscreen with broad spectrum coverage.
Click to expand...

Thanks for your reply.

What about for male patients in their 20's?

Would retin-A be something they could use for long-term prophylactic treatment of wrinkles?

Or should it only be used for female patients?

FatKid
 
chitowndermie said:
Retin-A is fine for women in their twenties. Since it also helps with acne (specifically the comedonal type) they will also benefit from topical vitamin A. The only caveat? Insurance companies stop paying for Retin-A (and every other topical vitamin a for that matter, ie. tazarotene and adapalene) after a certain age in their twenties. I do not recall offhand but it is somewhere in the mid-twenties. So if they want the cream, it is self pay. A 30 gm tube runs about 130.00 (haven't checked in a while), but will last up to four months. Hope that helps. Every one of my colleagues uses Retin-A or some other derivative. I truly believe it helps. The most important thing for young women, though, is daily sunscreen with broad spectrum coverage.
Click to expand...

Same at our program. Guys too :laugh:
 
FatKid said:
Thanks for your reply.

What about for male patients in their 20's?

Would retin-A be something they could use for long-term prophylactic treatment of wrinkles?

Or should it only be used for female patients?

FatKid
Click to expand...

Bump
 
how much of it do you use? and how often? i feel like i use smaller than a pearl sized amount because i'm scared it will irritate my skin
 
FatKid said:
What about for male patients in their 20's?
Click to expand...

The biggest thing at that point in your life is sun-screen.

For a guy, the best thing are simple products. I personally wouldn't think most younger people are good candidates for Retin-A as you're not likely to avoid the sun exposure that goes along with the outdoor activity most of us do at that point in your life. Retin-A can photosensitize your skin.

For a guy, I think a product like Neo-Cutis' Biogel is a good fit. It's not too expensive $100-150 per bottle which will last 3-4 months. Compared to most products, the science and histology behind their proprietary ingredient is fairly credible. They also have a product "Journee" for daytime use that has a 30SPF sunscreen. I think that companies product line is a nice & reltively afforadble way to introduce anti-aging products to men
 
chitowndermie said:
Retin-A is fine for women in their twenties. Since it also helps with acne (specifically the comedonal type) they will also benefit from topical vitamin A. The only caveat? Insurance companies stop paying for Retin-A (and every other topical vitamin a for that matter, ie. tazarotene and adapalene) after a certain age in their twenties. I do not recall offhand but it is somewhere in the mid-twenties. So if they want the cream, it is self pay. A 30 gm tube runs about 130.00 (haven't checked in a while), but will last up to four months. Hope that helps. Every one of my colleagues uses Retin-A or some other derivative. I truly believe it helps. The most important thing for young women, though, is daily sunscreen with broad spectrum coverage.
Click to expand...

Same at our program (both guys and girls), we tend to use it at night before bed to decrease the photosensitizing effects.
 
Long Dong said:
Same at our program (both guys and girls), we tend to use it at night before bed to decrease the photosensitizing effects.
Click to expand...

Would there be any qualms about writing this for myself? I obviously wouldn't write narcotics for myself, because that would be shady.

No offense, but I don't want to pay $200 to see a dermatologist when I can write this script for myself?
 
Thanks for your reply.

I assume there is no way to get Retin-A without a prescription?

Is there a website that lists what states self-prescription is illegal in?
 
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Best way is to probably see what your co residents do. I've noticed self prescription going on at my program so I would be inclined to perhaps try it

I'm also fairly certain any retinoid requires a prescription considering its teratogenic properties
 
asmallchild said:
Best way is to probably see what your co residents do. I've noticed self prescription going on at my program so I would be inclined to perhaps try it

I'm also fairly certain any retinoid requires a prescription considering its teratogenic properties
Click to expand...

Yeah, I knew Vit A caused problems in women trying to get pregnant, so it would probably require a script.

Correct me if I'm wrong, but ANY M.D. can write a script for Retin-A (even a surgeon). It doesn't have to be a dermotologist?
 
I tell patients to try any of the over the counter stuff with retinol, RoC makes a cheap over the counter one.
 
Dr. Oliver, I'd question any product, like NeoCutis, that touts hyaluronic acid. That is a large branching glycosaminoglycan which in all likelihood would not penetrate the stratum corneum to any great extent to provide the benefits that NeoCutis is claiming. It would need to get into the dermis to do what the molecule naturally does there.

I would never spend $$$ on those types of cosmetics for no confirmed gain. Dropping a couple Bennies on that is a waste.

But I'm always open to being enlightened if I'm wrong.

Generic retinoids are where it's at.

And yes, any MD can write the script. However, getting your insurance to cover an orthopod's script for a retinoid would be difficult, especially given that they challenge dermatologists' scripts on a regular basis and deny people over the mid-20s.
 
Long Dong said:
I tell patients to try any of the over the counter stuff with retinol, RoC makes a cheap over the counter one.
Click to expand...

I was curious about how well the OTC brands work. I am in FM, not derm, and patients ask me about them. What about the neutrogena brand. It is cheaper than RoC. Actually tried to find the %active in the OTC brand without luck so I wasnt sure if there was enough to even be worth the $.
Thank you for any advice.
 
Long Dong, asmallchild:

Do you guys use the gel or the cream?

What % do you use? 0.02? 0.05? 0.1?

Thanks,

FatKid
 
FatKid said:
Long Dong, asmallchild:

Do you guys use the gel or the cream?

What % do you use? 0.02? 0.05? 0.1?

Thanks,

FatKid
Click to expand...

I don't know if this thread is headed towards the dreaded medical advice arena but I use the gel as my face tends to be a bit oilier. I also use the 0.1% strength.
 
asmallchild said:
I don't know if this thread is headed towards the dreaded medical advice arena but I use the gel as my face tends to be a bit oilier. I also use the 0.1% strength.
Click to expand...

Yeah this thread is getting there. It had some educational points but is becoming medical advice. Let's just stop this.
 
I'm not sure how asking someone what strength % they recommend is seeking personal medical advice?

Nonetheless, I would like to see this conversation continue (of course under acceptable TOS rules)

I feel this is an important issue in medicine, because of vast amount of false advertising in the community and many different products claiming to have an effect.

Since prophylactic use for anti-wrinkle treatment is still a "new" phenomenon, I think a few of the following questions are valid:

1. What strength do you all use? (thanks asmallchild for contributing already)
2. Do you prefer gel or cream?
3. Do you use it everyday before bedtime? A few times a week?
4. Is there any sideeffects other than the contraindication for pregnant women you all have noticed?

Thanks,

FatKid
 
I think points 3 and 4 do fall under the umbrella of medical advice. Those questions can be addressed by visiting your friendly neighborhood dermatologist.
 
Yup, I agree... the only thing the answer would lack would be a Dispense: "x amount" and it would be a full prescription as well as a discussion of what to expect/watch out for... Prob ought to close the thread....
 
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