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Tazarotene for Wrinkles and Photodamage

Tazarotene is a topical retinoid with proven anti-acne activity. To determine whether, like tretinoin, tazarotene can also repair facial photodamage, these investigators conducted a manufacturer-sponsored, prospective, multicenter, investigator-masked, parallel-group study. A total of 349 subjects with at least moderate facial photodamage were randomized to treatment with tazarotene cream (0.01%, 0.025%, 0.05%, or 0.1%), tretinoin emollient cream (0.050% [Renova]), or vehicle control every evening for 24 weeks. Photodamage was evaluated on a 6-point scale, and global response to treatment was measured on a 7-point scale ranging from worsening of photodamage to total resolution.

Compared with control subjects, active-treatment subjects had significantly better improvement of fine wrinkling, mottled hyperpigmentation, and photodamage at 2 weeks. There were sporadically significant differences at various time points among the active-treatment groups. Treatment success -- defined as improvement in photodamage of at least 50% -- was achieved by 67% of the 0.1% tazarotene group, 52% of the 0.05% group, 36% of the 0.025% group, 41% of the 0.01% group, 55% of the tretinoin group, and 23% of the control group. With the exception of 0.025% tazarotene, treatment success was significantly better with the active formulations than with vehicle. Compared with biopsy samples from 4 control subjects, samples from 27 active-treatment subjects showed greater increases in epidermal thickness and a greater reduction in melanin content of the epidermis. No significant dermal changes were found. Optical profilometry showed no significant differences among groups. Overall, 59% of subjects reported mild-to-moderate peeling, itching, dryness, redness, or burning; 5% of each treatment group dropped out because of these adverse effects.

Comment: This well-controlled study clearly demonstrates that prolonged tazarotene treatment is as effective as Renova treatment for improving photodamage and fine wrinkles. The highest tazarotene concentration may actually be more effective than Renova. To reduce the risk for redness and peeling, patients should start with a mild retinoid, such as Renova, and then switch to gradually increasing concentrations of tazarotene as the skin becomes acclimated. The lack of histologic, dermal, or optical profilometry changes in this study is disappointing, however, making one wonder whether improvements will be long lasting or disappear once treatment is stopped.

— George J. Hruza, MD

Published in Journal Watch Dermatology January 30, 2002

Citation(s):

Kang S et al. Tazarotene cream for the treatment of facial photodamage: A multicenter, investigator-masked, randomized, vehicle-controlled, parallel comparison of 0.01%, 0.025%, 0.05%, and 0.1% tazarotene creams with 0.05% tretinoin emollient cream applied once daily for 24 weeks. Arch Dermatol 2001 Dec; 137:1597-604.

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