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Topical Vitamin A Versus Vehicle Cream in the Treatment of Aged Skin

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00272610
Recruitment Status : Completed
First Posted : January 6, 2006
Last Update Posted : June 24, 2015
Information provided by:
University of Michigan

Brief Summary:
The objectives of this study are to evaluate the safety and efficacy of 0.5% retinol (Vitamin A) versus it's vehicle cream in the treatment and prevention of skin aging and Bateman's Purpura (bruising).

Condition or disease Intervention/treatment Phase
Skin Aging Purpura Drug: 0.4% Retinol Cream Phase 2

Detailed Description:

Human skin becomes thinner and looses its elasticity with increasing age. These features of intrinsic skin aging are due to reduction in collagen synthesis with a concomitant increase in collagen and elastic fiber breakdown by matrix metalloproteinase (MMPs). In addition to these changes that occur simply from the passage of time, skin that is chronically exposed to the sun undergoes accelerated aging process referred to as photoaging. Here sun causes further alterations in dermal matrix by transiently inducing MMPs with each irradiation. Bateman's purpura (BP) is a bruised lesion that is commonly seen on the sun-exposed extensor surfaces of forearms and hands in elderly individuals. It is of no medical significance. However, to those afflicted, BP is often a great source of distress for its unsightliness and the obvious sign of aging it represents. The pathophysiology of BP has not been rigorously studied. Its exclusive presence on the sun-exposed surfaces of frequently traumatized areas suggests that photoaging associated loss of supporting structures around cutaneous blood vessels render the vessels easily torn by shearing injuries, thus causing purpura.

Topical use of tretinoin (RA) 0.1% cream has been demonstrated to improve clinical as well as histologic changes associated with photodamaged skin. Improvement in skin wrinkles by RA appears to be related to dermal changes. RA causes accumulation of epidermal and dermal TGF-alpha 1, a cytokine known to stimulate the synthesis of collagen I and VII, both of which, by ultrastructural criteria, are increased by RA in photodamaged skin. In fact, induction of dermal collagen formation by topically applied RA has been demonstrated in animal studies, and this has been confirmed in human studies. Therefore, it is postulated that topical treatment of BP prone skin with RA would buttress up cutaneous blood vessels by increasing the supporting collagenous structures around them. Such vessels ought to withstand shearing forces better, which would lead to some protection against the development of BP.

Retinol is a precursor to RA. When applied to human skin, it mediates all the effects that RA causes, but does so with much less skin irritation. Therefore, it is expected to be better tolerated by elderly skin than RA. In a seven day treatment study of elderly patients, retinol has been shown to induce mRNA levels of procollagen molecules in human skin in vivo. Therefore, it is hypothesized to improve the thin skin of elderly by increasing the synthesis of more collagen in both the photoaged, and hence improve BP, and the intrinsically aged human skin without causing significant irritant skin reaction.

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Study Type : Interventional  (Clinical Trial)
Enrollment : 50 participants
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Double
Primary Purpose: Prevention
Official Title: Topical Vitamin A (All-trans Retinol) Versus Vehicle Cream in the Treatment of Aged Skin
Study Start Date : September 2000
Study Completion Date : February 2002

Resource links provided by the National Library of Medicine

Primary Outcome Measures :
  1. Surface Roughness
  2. Fine wrinkles
  3. Hyperpigmentation
  4. Purpura

Secondary Outcome Measures :
  1. Collagen content of skin biopsies
  2. Glycosaminoglycan expression
  3. CRABP-II expression

Information from the National Library of Medicine

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Ages Eligible for Study:   70 Years and older   (Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Male and female
  • 70 years of age or older
  • history of Bateman's purpura on arms
  • Relatively good general health and able to perform daily tasks

Exclusion Criteria:

  • Sensitivity to any formulation ingredients
  • History of Cardiovascular disease with continuing deficits (example: partial paralysis)
  • Participated in any clinical trials within last 30 days
  • Topical steroids or other drugs two weeks prior to study entry (short-term application of topical antimicrobials is allowed)
  • Hormone replacement therapy within last 6 months.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00272610

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United States, Michigan
University of Michigan
Ann Arbor, Michigan, United States, 48109
Sponsors and Collaborators
University of Michigan
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Study Chair: John J Voorhees, MD University of Michigan
Publications automatically indexed to this study by Identifier (NCT Number):
Layout table for additonal information Identifier: NCT00272610    
Other Study ID Numbers: Derm 443
First Posted: January 6, 2006    Key Record Dates
Last Update Posted: June 24, 2015
Last Verified: September 2006
Keywords provided by University of Michigan:
Skin Aging
Bateman's Purpura
Additional relevant MeSH terms:
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Blood Coagulation Disorders
Hematologic Diseases
Pathologic Processes
Skin Manifestations
Vitamin A
Physiological Effects of Drugs