Re retinoids for geriatric use: increased blood flow :hyperemia

July 12, 2002

I remember sitting in the exam room of my dermatologic surgeon and

glancing at a laminated poster which featured diagrams of retin-a's

ability to increase circulation throughout the nose and cheeks and

yield a blushed rosy complection. The laminate was targeting

geriatric age groups and showed finely illustrated diagrams

regarding increased blood flow to these areas. That was enough to

deter me.. coupled with the fact that every time i have attempted to

use any of the vitamin A derivative topicals always became

extremely red. Ironically, one of the dermatologists I saw tried to

put me on renova @ night.. i tried it one day... woke up red .. went

to see Dr. Brody a week later .... he said I would not benefit from

it.

Like I said before there is a strong possibility that what I am

experiencing is not rosacea... I can see that I may benefit from

longterm retin-a/differin use in that I have a very oily t-zone

which tends to feature comedones... blackheads and occasional acne

pustules... this is separate from the erythema..

hyperemia or excess blood flow to the area is not something I am

comfortable with and it seems that that property is an undisputed

quality of all the vitamin - A topicals.

I am sure it can be put in a much more eloquent or even pedantic

sense but that's the gist of my qualm with the retinoids.

Cordially,

WA

> I wanted to put in my two cents regarding topical retinoids and

> rosacea.

>

> I've been lurking here for months and have seen time and time

again a

> huge bias against their use, with many a poster offhandedly

> dismissing their use as unsuitable for rosacea.

>

> I'm not a doctor, nor do I play one on television, but I am a

> professional researcher. I have researched the medical literature

> extensively, and not only have I not seen any evidence that

topical

> retinoids are harmful for rosacea, but, to the contrary, have seen

> numerous studies supporting their use.

>

> Most of these relate to its effectiveness against the papopustular

> component. In addition, though, there seems to be strong evidence

> that the use of topical retinoids discourages the action of VEGF,

the

> compound that promotes angiogenesis. In fact, studies of the use

of

> retinoids to treat cancers (by inhibiting the growth of vessels to

> supply blood to a tumor) have begun to appear.

>

> The only evidence I have seen on this board or elsewhere that

> supports the view that topical retinoids shuld be avoided is the

fact

> that they can be irritating, and that Dr. Nase says they're bad.

>

> This is in contrast to the amount of concrete scientific evidence

> that points to thier effectiveness in rosacea.

>

> I was diagnosed with rosacea two years ago, and have been on retin-

a

> since the beginning. my skin is smooth, pale, clear, and my pores

are

> small. Before treatment I had both redness and breakouts.

>

> Not implying that they're for everyone. But, unlike many of the

> treatment options that are discussed on this board, there is a

> scientific literature addressing the action and usage of topical

> retinoids, and so am encouraging a fully informed, unbiased

> discussion of their merits.

>

> By the by, would be happy to send along relevant citations.

>

July 12, 2002