Balancing Efficacy and Tolerability in Retinoid Therapy

Michael Gold, MD, a dermatologist based in Nashville, Tennessee, with more than 30 years of experience, recently spoke with Dermatology Times about his longstanding involvement in retinoid therapy and his perspectives on emerging innovations.

Gold recalled his early exposure to tretinoin, noting that he was part of the original evaluations conducted by Albert Kligman, MD, PhD, when he was just 16 years old. He shared that tretinoin not only treated his acne effectively but also shaped his career-long interest in dermatology.

Over the years, Gold has observed how retinols, retinals, and retinaldehyde have remained integral to dermatology. “All these compounds are really important. Obviously, they all play a really important role in dermatology,” he said. Their established place in clinical care continues to influence both medical and aesthetic practice.

The discussion also focused on a newer formulation known as RetaXome. Gold explained that it is a retinal product delivered through exosomes, which he described as “retinol-infused exosomes.” According to him, this approach is showing signs of improved performance compared with traditional applications. “It’s giving us the ability, at least we think and have proven so far, that it actually gets deeper into the dermis,” he said.

Gold noted that early evaluations suggest this technology may provide visible improvements while maintaining good tolerability. He emphasized that, in his practice and research, these new methods are being assessed carefully. “It’s really different,” he commented, highlighting that the combination of retinal with exosome delivery could represent a meaningful step forward in topical therapy.

Throughout the interview, Gold emphasized both his personal and professional perspective on retinoid use. From his early experiences as a teenager to his current role leading a large dermatology practice and research center, he underscored the lasting significance of retinoids and the promise of new formulations such as RetaXome.