The reversal of the signs of ageing / aged skin is an important component of any form of facial surgery. The authors here have written a comprehensive paper detailing the biological process in skin ageing and role of topical retinoid therapy. The ageing pathoprocess is detailed and well written, down to the changes at the molecular level. The various retinoids and their mechanisms of action are discussed in detail. There is a good write-up regarding the evidence. There is a small discussion regarding their efficacy prior to LASER resurfacing (none), dermabrasion and chemical peel. There is some evidence of better outcomes here. The final part is a practical use guideline, succinct and well written. It is important to point out here, there are a number of retionoid preparations available, some of which have concentrations that are sub therapeutic. Also the major drawbacks are the side-effects and this is especially so, in those patients with ‘sensitive’ skin. Lastly the effects are not permanent and regress after cessation of use .This paper is well worth reading in its entirety for anyone that deals with the ageing skin.

Reversal of skin aging with topical retinoids.
Hubbard BA, Unger JG, Rohrich RJ.
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Sunil K Bhatia

Royal Shrewsbury Hospital, Shrewsbury, UK.

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