The appearance of photoaged skin is cosmetically unacceptable to many in our 
society. Ostensibly, avoidance of ultraviolet light and sunlight from early 
childhood is most desirable but not likely to happen in our culture. Tretinoin 
is the only pharmacologic compound shown to partially reverse some signs of 
photoaging. Improvement with tretinoin therapy has been quantified clinically 
and histologically. A major degree of improvement occurs in 6 to 12 months, and 
maintenance treatment one to three times per week may continue this response. 
Tretinoin therapy should optimally be used with daily moisturizer and sunscreen 
applications. Psychosocial benefits of tretinoin therapy, use of tretinoin for 
intrinsically aged or non-Caucasian skin, and higher-strength tretinoin therapy 
for severely photoaged skin need to be further explored. It is possible that 
some subsets of patients with photoaged skin may respond better than others.