Evaluation of Tretinoin Cream on the Integrity of Aged Forearm Skin

Evaluation of Tretinoin Cream on the Integrity of Aged Forearm Skin: an Open-label Within-subject Randomized Study

The purpose of this research is to determine whether once nightly application of tretinoin 0.1% cream to forearm skin reduces the frequency of skin tears and bruising (solar purpura), and changes skin thickness over a period of 6 months.

Easy bruising and tearing of forearm skin is common with aging and can cause activity restriction, infection, and pain. Chronic exposure to UV light from the sun causes skin thinning and loss of supportive collagen over time. Thin skin tears easily and blood vessels normally protected by collagen rupture, causing bruises. Tretinoin is a prescription vitamin A cream that has been shown to increase skin thickness and collagen. Tretinoin is FDA approved for treatment of acne. We are trying to figure out if putting tretinoin cream on the forearms of adults with thin skin prevents skin tears and bruising.

We are looking for 30 people with a history of skin tears in the United States. The VA Palo Alto expects to enroll 30 research study subjects.

Inclusion Criteria:

• Adult (55+)
• History of skin tears, at least 2 in the past month
• History of skin bruising (solar purpura)
• Ambulatory
• Able to apply topical medication to oneself

Exclusion Criteria:

• <55 years old)
• Pregnant or breastfeeding
• History of allergy to tretinoin
• History of atopic dermatitis, psoriasis, bullous skin disease, cutaneous lupus, or cutaneous T cell lymphoma.
• Planned cutaneous surgery on either forearm in the next 6 months
• Use of any topical medication on the forearms within past month
• Current or anticipated phototherapy of the forearms in the next 6 months
• Current or anticipated chemotherapy within the next 6 months
• Use of oral steroids within past month
• Current or prior isotretinoin therapy within past 6 months
• AV fistula of the arm