The most common side effect of topical corticosteroid use is skin atrophy. All topical steroids can induce atrophy, but higher potency steroids, occlusion, thinner skin, and older patient age increase the risk. The face, the backs of the hands, and intertriginous areas are particularly susceptible. Resolution often occurs after discontinuing use of these agents, but it may take months. Concurrent use of topical tretinoin (Retin-A) % may reduce the incidence of atrophy from chronic steroid applications. 30 Other side effects from topical steroids include permanent dermal atrophy, telangiectasia, and striae.
Finally, some of the most innovative peptides are neuropeptides (which claim to relax facial muscles, therefore reducing the appearance of wrinkles, similar to BOTOX). The most popular is called Acetyl Hexapeptide-8 or Argireline. One serum that includes Argireline is PCA Skin's Exlinea Peptide Smoothing Serum pHaze 25 (, $102) . Another example of this type of peptide is Syn-ake, a synthetic peptide that claims to reduce the depth of wrinkles and increase skin's smoothness. It is based on an ingredient that mimics the venom of the Asian Temple Snake. You can find this in serums such as Sonya Dakar MicroVenom EyeLift Complex (, $82) .
I have personally found my own set of directions very useful particularly for patients just starting out with a topical vitamin A product. This helps mitigate the irritation, dryness, redness, etc., that can develop early on and help keep patients motivated to continue using their products. This applies to stronger levels of retinol as well as prescription agents. As for the fear of using a topical Vitamin A product during the summertime. Applying such a product does not mean your skin will burn to a crisp if you go outdoors. It is certainly important that you wear a sunscreen daily (oil-free if you're acne prone) and pay attention to how much sun you're getting. But it doesn't mean just because it's summer you MUST give up your Retin A, etc. If you use a little common sense and a lot of sunscreen, you are unlikely to have problems. If you do have sunburn concerns, then consider a non-vitamin A product such as DERMAdoctor Photodynamic Therapy 3-in-1 facial lotion with broad spectrum spf 30 for your skin rejuvenation during the summertime.