5 Skin Care Tips for Retin A Users

Tips for Retin A Dr. Bailey dermatologist's skin care informationI continually receive questions from readers about how to use Retin A and the other prescription tretinoin products. It’s time for a roundup of my information on how I use tretinoin in a complete skin care routine.

My readers and patients know that I’m a big tretinoin fan; I love the results you get from this powerful anti-acne and anti-aging skin care product. It’s tricky to use though. Tretinoin doesn’t combine with some other key skin care ingredients, it’s light sensitive, you have to train your skin to get used to tretinoin, and your skin has to be perfectly dry before applying tretinoin or else it will cause even more irritation.

These three recent questions from different readers show how much confusion surrounds the use of this powerful skin care medicine:

Reader #1, Lori

(My dermatologist) gave me a prescription of generic Tretinoin .025%. I’ve been using it for about 6 weeks now. My question is, is it strong enough to minimize these lines or am I wasting my time on this dose?

Reader #2, Jan

Can use the Green Tea Antioxidant Therapy product with my Retin A. (Retin A  at .05% doesn’t do anything to my face, so I just bumped up to .1%) Q–So correct me if I’m wrong, but the order to apply these at night would be: 1) Retin A, 2) green tea product, and 3)  moisturizer (do I need a moisturizer)?
Q–How much time do you need between applying 1 and 2 and 3 since I also read on your blog you should wait 15-30 minutes after you wash your face for the Retin A?  Don’t want to be up all night…

Reader #3, Anna

I started using Retin A about a month ago and have had good results as far as the acne goes. I also bought your anti-aging antioxidant skin care kit, Replenix Eye Cream, Daily Moisturizing Face Cream for oil/normal skin, and the Calming Zinc face soap.  My question is, what morning and evening routine would you recommend for me to get the best anti-aging results? I want to use the products correctly to get the best bang for my buck, if you know what I mean.

What are the essential tips for correctly using tretinoin in your skin care routine?

Tips for Retin A#1:  Tretinoin goes on at night.

It’s light sensitive so apply it at night before retiring. Wash it off in the morning then apply your other skin care products.

Tips for Retin A #2:  Some ingredients will interfere with tretinoin.

Don’t mix glycolic acid, vitamin C, benzoyl peroxide, or salicylic acid with tretinoin cream. (Retin A Micro is less fragile, but it’s not my favorite product for anti-aging because all the really pivotal anti-aging studies were done on the cream formulation.)

You can still use these ingredients but apply them in the morning after washing off the tretinoin you applied the night before.

Tips for Retin A #3:  Skin has to be totally dry before you apply tretinoin.

Apply compatible products first, one right after the other, then wait 15 minutes or more before applying tretinoin. This lets the excess surface water evaporated from your skin, and that seems to matter for minimizing tretinoin-induced skin irritation. It means that if you are using products such as Green Tea Antioxidant Skin Therapy and the Daily Moisturizing Face Cream those products are applied right after washing. Wait 15 or more minutes, then apply the tretinoin. I recommend keeping tretinoin on the bedside table and applying it right before going to sleep.

Tips for Retin A - Green Tea Antioxidant Skin Therapy

Green Tea Antioxidant Skin Therapy

 

Tips for Retin A- Daily Moisturizing Face Cream Normal to Oily Skin

Daily Moisturizing Face Cream Normal to Oily Skin

 

Tips for Retin A #4:  Tretinoin-treated skin must be sun protected every day.

Tretinoin makes skin more sun sensitive. If you’re going to use it for all the good things you get from tretinoin treatment then you need to be committed to using broad spectrum sunscreen and a hat when you’re in the sun. I’m a big believer in mineral zinc oxide being the best sunscreen ingredient. Read more to see what products I recommend for my patients.

Tips for Retin A - Suntegrity 5 in 1 Natural Moisturizing Face Sunscreen

Suntegrity 5 in 1 Natural Moisturizing Face Sunscreen

 

Pick your product based on your skin type and skin needs. See my sunscreen comparison chart for a summary of key features in zinc oxide products.

Tips for Retin A #5:  Work your way up to the highest tretinoin level your skin can tolerate.

Your skin has to be trained to tolerate tretinoin, and more is better meaning you get more benefit from higher strength levels of the medicine. I tell people it’s like a weight training program because you have to start with weights you can lift and slowly, over time, you’ll lift heavier weights as you gain fitness. It’s the same with tretinoin. You start with .025% twice a week and eventually work to 0.01% nightly. I give you more detailed information in my post on How to Use Tretinoin Correctly.

 

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26 Responses to “5 Skin Care Tips for Retin A Users”

  1. Robin April 19, 2013 at 9:08 am #

    Thanks for the info! I have a question though. I currently have Refissa which I like. Probably because of the base. I also have 0.1%. Can I alternate nights or combine them to work up to the 0.1%?
    also what is the max strength needed to maintain for anti-aging?
    Thank you!!

  2. Linda April 19, 2013 at 9:39 am #

    Hi Dr. Bailey, Oh no! I’ve been using Retin A Micro .1% for years! And it even comes in a pump now which is beautiful to preserve the ingredients! I follow your advise religiously and buy your C/R/S and Glytone #3 and tolerate it all very well! I also use recommended cleansers, and lots of sunscreen. What exactly should I ask my dermatologist to write on the perscription now? I want brand name so would that be just Retin A .1% cream? I also read this (link below) about Retin A micro and thought you might like to see. I hope all these years of use wasn’t a waste. It’s very expensive! I’d also like to keep using the Retin A micro pump. But I follow your advise religiously, as I said, so I’d love to hear more!

    http://www.realself.com/question/retin-a-micro-wrinkles-retin-a-products

    Thank you!

  3. Linda April 19, 2013 at 9:42 am #

    P.S. I am using Retin A only for anti aging results :)

  4. jo April 19, 2013 at 10:43 am #

    Hi – can you use retin a with vaniqa? Thanks

  5. Christine April 19, 2013 at 8:35 pm #

    Dr. Bailey,

    Are all creams of tretinoin delivering the same benefits? In other words, is Retin-A better than Stieva, Renova, Retacnyl etc.?

  6. Ada Smith April 20, 2013 at 1:47 am #

    Hi Dr. Bailey,

    I am so in love with your blog and wish I could have found it earlier! I’m going through some of the older entries and I love when you do these roundups, they are so informative and helpful.

    I have been using retin a for years now but just discovered Suntegrity while reading some magazine article. OMG… it makes my skin look so incredible and it’s really good to know that you approve of the product. Also, thanks for writing that post about the product awhile back, I’ve learned so much about zinc oxide.

    I have a question regarding the spf 30… I think it’s sufficient for daily wear to and from work. Is it enough for running errands for 1-2 hours or a weekend walk around the city (1-2 hrs) around Spring season? Most importantly is it enough for the harsh sun rays of the summer? I usually wear spf 50-100 during the summer but I am so in love with Suntegrity that I don’t want to switch back. What to do Dr. Bailey? Please help!

    Thanks for all your hard work on the site.

    Sincerely,

    Ada S.

  7. Sonal April 21, 2013 at 5:02 pm #

    Dr. Bailey, I like your analogy of Retin A to a weight training program. Makes sense as to why rushing to use stronger concentrations is not a good idea.

  8. Cynthia Bailey MD April 22, 2013 at 9:48 am #

    Hello Robin,
    Since they are prescription I can’t make specific recommendations, only your treating physician can. In my experience the old fashioned tretinoin formula appears to be the most dramatic for photoaging. That said, I have many patients using old Renova like formulas when that’s what their skin does best with. I also have people work up to the highest of whichever of these they can tolerate, sometimes that means alternating with another product as you mentioned. I can’t say that mixing is ok because chemistry is complicated.

  9. Cynthia Bailey MD April 22, 2013 at 11:07 am #

    Thanks Linda. Tretinoin is the most studied and the best understood retinoid for treating photoaging. In fact, the scientific understanding of it’s wide range of benefits for photoaging is astounding! Product vehicle matters for efficacy and tolerability as side effects are what limit therapy for most people. One can’t assume that the scientific results of the original cream or emollient studies are entirely translatable to other vehicles. The micro is cleaver but again most of the really detailed scientific studies were done on tretinoin cream and the emollient tretinoin cream. Studies may show improvement in visible signs of photoaging or some of the biochemical improvements, but not the entire story. It’s all debatable and there is no absolute answer. I say to my patients to use what their skin will put up with and at the highest level and for the longest time possible. In my observation the original formula cream gives the best results, even better than the emollient cream formula (Renova). That’s what I go with, so I prefer, in order, the original (and brand over generic but read on), emollient base, then micro, then gel, then tazarotene, then retinol or adapalene. Initially when Retin A lost it’s patent and the generic came on the market, I observed that the brand tretinoin cream (Retin A) was still performing somewhat better than the new generics. The formulas are relatively equivalent but the cost and availability have become so problematic, and over time I’m able to get the same results with the generics so I’ve acquiesced and they are what I prescribe unless a patient specifically requests branded Retin A.

  10. Cynthia Bailey MD April 22, 2013 at 11:07 am #

    I have patients that do but both are prescription so that question needs to be asked of the prescribing doc.

  11. Cynthia Bailey MD April 22, 2013 at 11:08 am #

    See my answer to Linda below where I tackled it in detail.

  12. Cynthia Bailey MD April 22, 2013 at 11:16 am #

    Ada, thanks for such wonderful comments! I love that you love to read what I love to write.

    Regarding SPF, it’s very dose dependent meaning if you put enough of SPF 30 on you get pretty much the same protection as SPF 50 because the difference in uv absorption is negligible. If you don’t put enough on then it matter. Add to that that the non-nano zinc is super stable in the sun. It means that I feel really good about Suntegrity’s sun protection being “bullet proof” as I like to say to patients. Here are some of the articles where I discuss SPF issues

    http://www.drbaileyskincare.com/blog/how-high-of-an-spf-does-your-sunscreen-need-to-have/

    http://www.drbaileyskincare.com/blog/dermatologist-explains-the-new-2011-fda-rule-governing-sunscreens-what%E2%80%99s-changed-and-what-you-need-to-know/

    Looks like I need to do a roundup on SPF! Remember, you need a hat, sun parasol or shade too because sunscreen is there to protect from reflected light and what skin you can’t cover to prevent UV exposure to.

    Cheers

  13. Debra Blumfeld April 25, 2013 at 7:30 am #

    It is great to see such in depth and substantial articles on dermatology and skin care. I write articles for natural skincare products at St. Grape which is based in Canada. I will return here in the future for inspiration. Would you be happy to use information I find here in future blogs? I will make sure the source is clear on our website

    thank you for your time

  14. Cynthia Bailey MD April 26, 2013 at 7:36 am #

    Hello Debra,
    I’m glad you think the information in my articles may benefit your readers. You are welcome to quote me (but not copy my content) with full attribution and a link to my source page.

  15. Samantha Handley April 26, 2013 at 1:27 pm #

    Thanks for sharing these skincare tips Cynthia. I always enjoy and get good information from your articles.

  16. Linda April 26, 2013 at 2:19 pm #

    Hello Dr. Bailey, your response to my question was incredibly helpful and I’m sure was helpful for all your readers– ranking, in your opinion, the best tretinoin sources! I was just ready to head over to my doctor’s office to get a RX for Retin A cream .1% to use once I finish my .1% Retin A Micro, and have found after calling multiple pharmacies that it has been discontinued. I also couldn’t find Renova in the .1% strength. Is the generic cream .1% your second choice? Or do you prefer brand name cream at .05%? Or Renova at .05%? Have you found the Retin A Cream .1% to be discontinued? Thanks, as always for all you do!!

  17. Cynthia Bailey MD April 28, 2013 at 12:02 pm #

    We are having so many problems with the supply of our trusted dermatologic medicines these days, great products keep becoming unavailable and it’s a shame. The trade name tretinoin products are slowly being phased out. It’s why I’ve transitioned over to the generic tretinoin cream in my practice for the most part. For a more emollient (less irritating) option I’ve written for the Renova 0.02% and Refissa 0.05%. Some patients prefer these products though the 0.02% Renova is not as effective in my observation. Again, I mostly write for the generic tretinoin cream and feel that it works well in the step up concentrations. I keep advancing the strength at 2 month intervals until the skin tells us it won’t tolerate a higher concentration, or we get to the 0.1%. I hold there for a few years at which point we decide if we want to drop to alternate night dosing and have them apply glycolic acid on the non-tretinoin nights. Some patients elect to stay on nightly tretinoin and instead alternate glycolic acid and vitamin C during the day. Ideally we want all 3 of these great anti-aging ingredients added to the skin care routine if possible.

  18. Rae May 5, 2013 at 12:03 am #

    Hi Doc. Is it not ok to stay with 0.025%. My acne is manageable now and I’m only using it for anti-aging purposes. Do you think I still need to level up?

  19. Cynthia Bailey MD May 9, 2013 at 10:50 am #

    It’s what I do with my patients. Many of the studies for anti aging were done on 0.05%

  20. Janet Kooba May 25, 2013 at 12:19 pm #

    Dr. Bailey,
    I am using the brand name Retin A Microgel .1%. I noticed you have mentioned the original cream version is best for anti aging, and although I am about to turn 50, I am still acne prone. The cream version has an ingredient “isopropyl myristate”, that is apparently highly comedogenic. I do, however, want the best available for anti aging, without breaking out – any advise?
    Thank you!

  21. Cynthia Bailey May 29, 2013 at 7:19 am #

    Hello Janet,
    For years Retin A (tretinoin) cream has been highly successful for treating comedonal acne in many skin types; it has a long and well documented track record of success. That said, everyone’s skin is different. The Micro is an excellent acne treatment and the microsphere encapsulation of tretinoin gives Micro the added benefit of remaining active in the presence of other medicines like benzoyl peroxide, which would counter the classic Retin A Cream. The really compelling antiaging data has been collected on the cream and emollient cream formulas of tretinoin however and that is why I recommend them. I believe that if the Micro, or the gel for that matter, had great antiaging data it would have been published. In addition, to my observation, the cream form of tretinoin works the best for achieving antiaging skin care goals, which is why I stick with it.

  22. Janet Kooba May 29, 2013 at 12:12 pm #

    Thank you so much for your detailed, educational reply! One last question to clarify, do you feel the Micro has ANY antiaging benefits, or is it simply an acne treatment? Thank you again!

  23. Cynthia Bailey May 29, 2013 at 1:02 pm #

    Yes I think it has some, but the cream is the best in my opinion.

  24. Janet Kooba May 29, 2013 at 1:21 pm #

    Thank you! Love your blog, so grateful for your detailed advise and help!

  25. Premna Patel June 7, 2013 at 5:46 pm #

    Hi Dr. Bailey,

    I currently use generic retin a 0.025. I used to use retin a micro (but insurance no longer pays for it). I use the cerave pm lotion on top of my retin a. I have noticed that with the generic retin a gel, the product clumps on my skin after I apply cerave. I’m worried that with the clumping of the 2 products, the retin a isn’t working as well as it should. Do you know why retin a gel and crave pm clump together for me? And any advice on how I can avoid this? Thanks.

  26. Cynthia Bailey June 9, 2013 at 4:51 pm #

    Not all products mix well on the skin together. I usually have my patients use the tretinoin cream. I have them apply a moisturizer before, wait 15 min then apply the tretinoin. You will have to ask your prescribing doctor for modifications in your treatment as that is a medical advice issue.