Beyond tretinoin: cosmeceuticals for aging skin.

J Drugs Dermatol. 2009 Jul; 8(7): 674-7Bergstrom KGIn contrast to youthful skin, mature skin undergoes well-established clinical and microscopic changes, particularly after menopause. In particular, dermal thinning, loss of dermal collagen and decreased lipid production are complicated by the effects of life-long sun exposure. These changes manifest as wrinkling, loss of elasticity, dryness and textural changes that characterize mature skin. To effectively combat these age- and sun-related changes, a multifaceted approach is required. Any treatment for mature skin must address the many causes of skin changes, that is, collagen production, lipid balance and epidermal texture. Several currently available compounds have scientifically-established effects on skin, and are anticipated to be even more effective in combination. Women worldwide struggle with coming to terms with their aging skin, and seek ways to preserve its youthful appearance. While dermatologists' offices may offer tretinoin cream (Renova and related products), laser resurfacing approaches, volume fillers and Botox, demand also exists for topical products that preserve and improve skin tone. With the push toward "natural," "organic" and "herbal" products, public and private research has never generated more evidence for complementary therapy. During skin aging, and particularly menopause, characteristic changes occur. Topical compounds can target many aspects of the aging process. The following is a review of topical compounds that may help with particular parts of this process. How can different problems be approached? In addition to prescription approaches and physical modalities, several topical compounds, many available over the counter, show evidence for helping aged and photo-damaged skin. Clinical data exist for many of these compounds, and is divided by mechanism of action.