BACKGROUND: Topical retinoids are used to treat the visible signs of photoaging. 
While efficacious, they are irritating.
OBJECTIVE: Evaluate the effectiveness and tolerability of a double-conjugate 
retinoid cream (AlphaRet Overnight Cream; AHA-Ret) in improving visible signs of 
photoaging vs 1.0% retinol or 0.025% tretinoin.
METHODS: A 12-week, split-face, randomized trial was conducted in 48 female 
subjects, aged 30-65 years with mild to severe photodamage. AHA-Ret was applied 
to one side of the face and either retinol (n=24) or tretinoin (n=24) to the 
other side (PM). Expert blinded evaluation of images and Nova measurements 
occurred at 4, 8, and 12 weeks. Tolerability was assessed throughout the study.
RESULTS: Forty-seven subjects completed the study. AHA-Ret demonstrated 
significant reductions in average severity from baseline: Fine Lines/Wrinkles 
(P<.001; all time points); Erythema (P=.004, P<.0001; 8 and 12 weeks, 
respectively); Dyschromia (P<.0001; all time points); Skin Tone (P<.0001; all 
time points), and Pore Size (P=.035, P<.0001; 8 and 12 weeks, respectively). 
AHA-Ret induced less Erythema vs retinol at 8 (P=.008) and 12 (P<.02) weeks. 
AHA-Ret was noninferior to prescription tretinoin in all categories at 4 and 
8 weeks, and for Fine Lines/Wrinkles, Erythema, Dyschromia, and Skin Tone at 
12 weeks. Improvements in Hydration occurred at every time point with AHA-Ret 
only (P<.04, P<.03, P<.01). Less irritation was reported with AHA-Ret vs retinol 
or tretinoin.
CONCLUSIONS: Treatment with a double-conjugate retinoid cream demonstrated early 
reductions in photodamage and improvements in Hydration. AHA-Ret induced less 
Erythema vs retinol and was more tolerable vs retinol and tretinoin.