Retin A, AHA?

[Ruvaida]

Hello,
I'm using retin-A know, it literaaly dries my face and gets rid of the oild. Could this be bad for my dry eyes?

Another thing, some anti-wrinkle products that I'm using do have AHA (alpha hydroxy acid) which too "peels" the skin.
Could this be of harm?
I'm changing my eye Cream to a one that does not have AHA just to be safe, but what about the face cream?

[ishkane]

I use retinoids (tretinoin) and AHAs, and i don't find they make my eyes worse. The tretinoin I use is in an alcohol base, but it evaporates quickly, so there's no stinging (of my eyes). I just make sure to keep them away from my eyes. I know some people use retinoids on their eyelids, but that's not something I've ever done.

[spmcc]

I've been doing some research on hyperkeratinization which is reported to be a histopathological observation (or characteristic) of obstructive MGD. This led me to search on drugs used to combat hyperkeratinization. The retinoids are mentioned.

Anyway, long story short, I then stumbled onto a journal article by David Sullivan (one of my favorite researchers) in Exp Gerontol July 2012: http://www.ncbi.nlm.nih.gov/pubmed/22569356

They write

Of note, retinoids which are used in current anti-aging cosmetics may promote the development of MGD and dry eye disease.

I'm so confused!!!

[Ruvaida]

Ishkane,
Thank you for your reply. I have a cream for the eye lids and eye counture. I think I should hold it for now at least.

[Ruvaida]

spmcc,
Oh! I've been using Retin A and it seemed that my dry eyes started the same year I did this :S
How does this happen, I mean by retin A getting into my eyes, or via its absorption into my body and taking the usual cycle?
Nothing works for my acne but retin A, but my eyes are really badly red these days.

Thanks for the link, I'll have a look at it.

[littlemermaid]

Guys, It's a while since I read up on this so I did a quick search on PubMed 'retinoid meibomian gland' and it's all there. We tried topical Adapalene on the chin for acne and I am sure I saw golden gunk coming out of a meibomian gland on one lower eyelid, similar to what was happening to the sebaceous glands on the chin. So we stopped. The gist is that retinoids change sebaceous glands, this is how they work for bad acne. The derms, without conceding, said 'but you're using it nowhere near the eyes'. Me 'how do nicotine patches work if there's no absorption'. Them 'there is no trace of systemic absorption'. Me 'then why are some topical creams teratogenic'. Famous derm Prof, shouting and losing his rag in front of entire class of post-grads '(excess) vitamin A does not cause eye problems'. Underling 'discharged'.

The moral of this tale is, dermatologists are not current on how their topical treatments affect eyes. And, 'keep away from eyes' is insufficient advice.

[jenny2008]

my opthamologist mademe stoptaking retin a... he said even tho applied topically and not near the eyes it can absorb..etc... however i took it for about 7 years.. dry eye didnt come until about 2 years laterbut so did my dry mouth,etc..allmysjorens syndromes... i was diagnosed with sjogrens age 21..my doc thinksthat my mgd is fromsjogrens as 50% of people with sjogrens get the mgd...however, he said there is no reason to throw fuel to the fire..

now for occasional breakouts i just use benzoyl peroxide and sulfer masks..otc..nothing with retin a or retinoid derivitives.. i hvae been off the retin a for about 2 months now.. i am hoping my gland willget better..however a lot of my dryness is fromnot making enough tear and it moves around from eye to eye-that is sjogrens and again i was diagnosed with that over a decade before i treid retin A... My derm said its completelty safe but he
also rx'd something for my eyelids that says not to use near the eyes??? i am just keeping my red eyelids-i use clinqiue or almay concealer when leaving the house--i dont want to further arravate my eyes.. i wouldbelearly

[spmcc]

How does this happen, I mean by retin A getting into my eyes, or via its absorption into my body and taking the usual cycle?

In the journal article, the authors discuss RA (retinoic acid) and its derivatives:

* RA is highly effective in reducing sebaceous gland size by inhibiting sebocyte proliferation, differentiation and sebum production. Not surprisingly, RA causes MGD and dry eye disease, given that meibomian gland is a sebaceous gland.

* RA causes keratinization and thickening of the meibomian gland ducts, degeneration and necrosis of the acinar cells, fibrosis of the periacinar tissue, and reduced lipid content in meibomian gland.

* In the sebaceous gland, RA decreases basal sebocyte proliferation, prohibits sebocyte terminal differentiation, induces sebocyte apoptosis, and suppresses sebum production up to 90%.

* In addition, RA may suppress androgen receptors and inhibit retinol dehydrogenase-4 in sebaceous glands, which would diminish the local, intracrine production of dihydrotestosterone (DHT).

* This indicates that not only does RA inhibit androgen action in the sebaceous gland, but disruption of an important androgen target gene also leads to enhanced RA activity, therefore androgens and RA have antagonistic actions in the sebaceous gland. By analogy, these actions of RA would similarly attenuate androgen activity in meibomian gland and lead to MGD.

Keep in mind that Sullivan is very interested in androgen-deficiency and dry eye/MGD.

There was more with a lot of references. So if you're interested, you will need to read the whole article.

[littlemermaid]

Spmcc, I'm interested! but Elsevier want $30 to read the article... Hopefully soon we'll be able to read more articles online for free. Thanks for the summary - excellent.

[jenny2008]

my neck is breaking out so bad and again my derm just gave me samples of things with retinoids in them.. he insists they will not absorb into the skin...... i told him that they would possibly make my mgd worse and he said they wouldnt..

can anyone help??? are topical retinoids just as bad as taking them internally???
if so what can i use for the acne?? i am at a loss!

what can we use?? is alpha hydroxy ok?