Skin Anti-Aging Effect of Oral Vitamin A Supplementation in Combination with Topical Retinoic Acid Treatment in Comparison with Topical Treatment Alone: A Randomized, Prospective, Assessor-Blinded, Parallel Trial

Abstract

Topical retinoid treatment is considered a standard therapeutic approach for chrono and photo skin aging. Retinol (vitamin A) is the precursor of endogenous retinoids. A prospective, 12-week, randomized, parallel-group trial comparing the combination of vitamins’ oral supplementation (one capsule daily, 50.000 UI vitamin A and 50 mg vitamin E) and a 0.02% retinoic acid topical gel formulation (RG) applied in the evening (Group B) in comparison with the topical RG treatment alone (Group A) was conducted. A total of 60 subjects (men and women, aged >50 years, mean age 60 ± 8 years) with moderate-severe facial skin aging (Glogau score > 2) were enrolled after their written informed consent. Thirty participants were randomly assigned to Group A and 30 to Group B. The primary endpoint was the clinical evaluation of a Skin Aging Global Score (SAGS), at baseline, and after 6 and 12 weeks. A VISIA® (Canfield Scientific, Parsippany, NJ, USA)face sculptor analysis was performed in a subgroup of 20 subjects. Skin tolerability was evaluated in both groups at weeks 6 and 12. In comparison with the baseline, SAGS scores in both groups were reduced by 13% (Group A) and by 14% (Group B) after 6 weeks and by 22% (Group A) and by 27% (Group B) at week 12. At the end of the study, SAGS score absolute reduction in Group B was significantly greater (p < 0.01) in comparison with the absolute reduction in Group A. Both treatment regimens were well tolerated. The combination of medium-high doses of oral retinol supplementation (Vitamin A) and topical retinoic acid gel showed superior efficacy in terms of clinical improvement in comparison with the topical treatment alone in subjects with moderate/severe skin aging.