Ask Dr. Bailey: How to Apply Retinoids

 

Ask DB Rentinoid_Main

AskDrBailey3Hello Dr. Bailey,

I have a question. I am considering getting a prescription retinoid, possibly renova in the lowest concentration since I think it is best for anti-aging purposes. My concern is that I really don’t want the irritation and dryness that comes with using prescription retinoid. Is there any way to avoid irritation or is there a guarantee that irritation would occur if I decided to use prescription tretinoin? ~from Miyako

I love the impact of retinoids for slowing skin aging. I have used them myself for over 30 years and have thousands of patients using them too, including people with sensitive complexions. I have written extensively on why I love retinoids on both my blog and on the information-packed pages of our online store. I have also written on how I use them in my practice. Here, I want to recap the skin care benefits of retinoids:

Retinoids can help:

  • Boost your skin’s collagen turnover to help fight wrinkles and skin aging
  • Increase epidermal cell turnover to brighten your complexion and to help prevent clogged pores, which is one of the key steps credited to starting acne
  • Even out uneven pigment in sun spots and melasma
  • Reverse the early steps in pre-cancer and skin cancer cell formation

The bottom line is that there are so many reasons to use a retinoid product that I prescribe them abundantly!  Remember, however, if you are using a prescription product, it is your prescribing doctor that is 100% in charge of how you use the medicine, including the steps you use to reduce or prevent irritation.

16

Retinol Intensive Night Cream

To help lower the risk of retinoid irritation and retinoid dermatitis, I counsel patients to “start low and work slow” to incorporate a retinoid into their skin care routine. This is because skin has to adjust to retinoid therapy. All other products used often need to be adjusted for sensitive skin to tolerate a retinoid. 

This advice applies to ALL retinoids. In my practice, I have patients on different forms of retinoid skin care products because both prescription and non-prescription products work well. Many people choose to use our non-prescription Retinol Intensive Night Cream for its convenience and because many people find it less irritating than Retin-A. Both I and my aesthetician incorporate our Retinol Cream into skin care routines as a night cream. Remember that retinoids are inactivated on contact with light, so they should be applied right before bed for the best results.

I always stress that any professional product like Tretinoin or my Retinol Night Cream be used in a supportive complete skin care routine for best results. This is particularly important with a retinoid used on sensitive skin. Also, retinoids can make skin more sun sensitive, so sun protection products have to be taken into consideration too.

To recap: with retinoid therapy, all products including cleansers, correcting products, moisturizers and sunscreens need to be chosen to support results and reduce the risk of skin irritation and sun sensitivity.

toleriane

Toleriane Cleanser

In my practice, I build a complete skin care routine for retinoid use as follows:

Naturally Hydrating Pore-Minimizing Facial Toner

Naturally Hydrating Pore-Minimizing Facial Toner

Skin Cleansing: I choose a cleanser that is not irritating for a person’s retinoid treated skin. Options for sensitive skin include Toleriane Cleanser or other soapless cleansers designed for sensitive skin. For an extra level of clean, my Hydrating Toner works well to get the last vestiges of product, dirt and oil off skin without drying.

Oily and acne-prone skin often do well with my Foaming Acne Cleanser or Glytone Gel Wash Cleanser. Also, my simple Naturally Best Bar Soap works for many skin types and is super economical!  All these products can be used with a Clarisonic System, a facial Buf Puf, a wash cloth or your hands depending on which is best tolerated. 

Complexion Correcting Products: With retinoid use, I add water-binding and irritation-fighting products such as my Instantly Luminous Serum and my Green Tea Antioxidant Power of Three Cream. The combination helps to soothe early irritation. These are applied right after cleansing skin in the morning. At night, the correcting step is the retinol product which can be applied after the Serum and Green Tea or alone.

Instantly Luminous Multi-Action Serum

Instantly Luminous Multi-Action Serum

Skin Hydration is balanced with the Serum plus a moisturizer that fits your complexion. Favorite options include my Facial Creams for Dry or Oily skin and my natural Lotion or Butter for extremely dry skin. These are compatible with all my products.

Sun Protection is critical, and the last product applied every day!!  Makeup, if used, goes on top and is NOT a substitute for sunscreen. Pick the right sunscreen matched for your complexion and product preferences using my sunscreen guide which helps you see the important characteristics that matter when choosing the sunscreen that is right for you.

All Natural Face and Body Butter Cream

All Natural Face and Body Butter Cream

With retinoid use, I stress building a complete routine because, using one product alone, is not as powerful as using supporting products if you want good results. Patients and clients in our office tell us every day how happy they are with their complexion once they start using retinoids along with their complete skin care routine. Interestingly, the more years they use the retinoids, the more obvious it is that retinoids really do slow skin aging.

I’m a big fan of retinoid skin care, in case you haven’t noticed! Whether prescription Tretinoin or non-prescription professional Retinol as in my Retinol Intensive Night Cream, almost every complexion stands to benefit from the power of topical retinoids.

Best wishes with your retinoid therapy!

Warm Regards,

Cynthia Bailey MD, Dermatologist

The information in the Dr. Bailey Skin Care web site, and related links, articles, newsletters and blogs, is provided for general information and educational purposes only. It is the opinion of Dr. Cynthia Bailey, or other indicated authors. Consult your physician or health care provider for any specific medical conditions or concerns you may have. (This also applies to patients in her medical practice; the information here is not a substitute for, or an extension of, the medical care she provides for you.) Never disregard professional medical advice or delay seeking it because of something you have read here. Use the information and products on this site at your own risk. Use of this site indicates your agreement with these statements and the Terms and Conditions of DrBaileySkinCare.com. If you do not agree to all of these Terms and Conditions of use, please do not use this site!

 

If you found this helpful, subscribe to my blog -- it's free. I write two articles per week on skin care and skin health and you can have them delivered to your email inbox. Get your skin care information straight from the dermatologist. Join my intelligent skin care revolution. Just enter your email address:

  

Tags: , , , , , , ,

14 Responses to “Ask Dr. Bailey: How to Apply Retinoids”

  1. Jody R. February 15, 2016 at 8:27 am #

    Dr. B., do I understand you post to say that you recommend using both the Instantly Luminous Serum and the Green Tea Antioxidant Power of Three Cream at the same time? Or are you recommending that I choose one of the two products, but not both at the same time? Thanks!

  2. Cynthia Bailey, M.D. February 15, 2016 at 10:23 am #

    Hi Jody, Yes, depending on a person’s complexion these are wonderful collaborative products. The HA in the serum is different in that it has multiple molecular weight sized HA to stratify within the skin’s layers. It also has sodium PCA which holds water differently. The Green Tea has the antioxidants and more HA. The serum takes a few seconds to dry so I do something like brush my hair. Then I pat in the Green Tea. My Erythermatotelangiectatic Atopic Seborrhea and Retinoid Dermatitis prone old lady complexion drinks this combo up and LOVES it! The serum is a game changer. Now, in humid climates or on really oily complexions it may feel like too much to have the two on at the same time, however, it also may mean less need for moisturizer everywhere. The layering is dialed in as needed so that skin looks and feels wonderful. A fun story is that I was just visiting in Australia for their summer and brought Dr. Bailey Skin Care care packages for my friends. It was hot and humid and their skin absolutely changed within days of using this combo in the day with either the Suntegrity or the Pure Mineral sunscreen and the Retinol AND/or Glycolic Acid ream at night. It was fun for me to see such rapid results during my stay. Hope that helps, thanks for the great question.

  3. Lolita February 15, 2016 at 1:49 pm #

    Hi Dr. Bailey,

    I have just discovered your website – I am delighted to be here!!

    I have been using 00.05% (Obagi ) Tretinoin for years and will continue with a prescription strength from my Pharmacy in the future.

    Question: I currently use Obagi Vitamin C serum and was wondering if that would be compatible with the other products you recommend for those of us who use Tretinoin….tuminous Serum and the Green Tea Antioxidant Power of Three Cream.

    Also, do you offer a ‘package/kit’ for Trentinoin users?.

    My skin is healthy, looks great – I am 75 – looking to continue the good start that Nature and Tretinoin gave me….like the rest of us, I want to maintain firmness, diminish wrinkles, correct sun damage and use appropriate products.

    Thank you.
    I am already a fan!

  4. Joanne Hock February 15, 2016 at 8:43 pm #

    Hi Dr. Bailey,

    Thank you so much for this clarification. I have been using a dermatologist prescribed 0.1% Trentinoin cream for 3 years, along with a retinol eye cream and a 10% glytone gel wash. I am 58 and prone to occasional oily T zone-acne flare ups/rosacea flare ups, I have learned more from your website and blog from trying to handle the rosacea, to the importance of cell turnover, and good skin care.

    I along with your customers and blog followers, truly appreciate the “realness” of you, had I not read to wait 20 minutes after cleansing your at night before applying the tretinoin cream – that you keep it at your bedside…and I will be reading your sunscreen guide next. Thank you.

    Recently my dermatologist, said I could discontinue my Trentinoin at bedtime and use a good sunscreen as my daily skincare! Time for a new physician! Unfortunately I am on the east coast.

    I would like to purchase your recommended products and Calming Zinc bar soap to use for Rosacea (unfortunately avocado and spicy foods do me in) is there a customer rep that could help me choose from the above products?

    Would you kindly steer me in the right direction…can I purchase the Retinol Intensive Night Cream and expect to see results or do I need to have the same 0.1% prescribed from a dermatologist? I realize you cannot give me a consultation over the internet and I am responsible for the products that I would like to purchase.

    Again thank you for your time and expertise.

    Sincerely,
    Joanne

  5. Cynthia Bailey, M.D. February 16, 2016 at 8:39 am #

    Hello Joanne, I will ask Danielle, my aesthetician, to contact you. She knows our products well and we have many many many many patient with rosacea and T-zone misadventures in “our” delicate age group – myself included in all of the above.
    Warmly,
    Cynthia Bailey MD

  6. Cynthia Bailey, M.D. February 16, 2016 at 8:56 am #

    Hello Lolita and welcome! I and my team are, like you, passionate about helping to keep skin healthy and attractive with smart skin care routines. I love your idea of a tretinoin kit! We are building a new web site and hope to launch it soon. That is exactly the type of skin care support I hope to help people achieve with the new site. Our old site has been wonderful but we need new technology to help people build their perfect kits.

    Regarding your question, Vitamin C serum is a great skin care ingredient. I have people use it during the day, not layered with tretinoin at night. We have a really well made Vitamin C Serum that I think is the best of all vitamin C serums made today because it has technology to protect fragile vitamin C from inactivation and to deliver it to the skin effectively. I often build this product into a comprehensive complete antiaging skin care routine as follows: During the day, Cleanse, Serum, Green Tea, Vitamin C, Moisturizer where needed, Zinc Sunscreen. If the sunscreen is also moisturizing (such as Suntegrity BB Cream) then those last steps can be combined. At night I have people apply the Green Tea, moisturizer if needed, wait 15 to 30 min, tretinoin right before retiring and turning out the light for sleep. I hope that gives you some ideas.

    Warmly, Cynthia Bailey MD

  7. Sophie February 16, 2016 at 10:19 pm #

    Hi Dr. Bailey,

    I, like the other commenters, have benefited a lot from your advice. I really appreciate how detailed your guidance is! Especially for someone like me who has an intense case of rosacea.

    Regarding this discussion on retinoids, how do you feel about their use on the neck and chest? I have deep vertical chest wrinkles – I think from sleeping on my side as well as sun exposure. I have used an OTC Neutrogena product which contains retinol for over a year, and I don’t think it has lessened the depth or the number of wrinkles. Would using a prescription product have more of a chance of success?

    Thanks for your time!

  8. Cynthia Bailey, M.D. February 17, 2016 at 8:42 am #

    Hello Sophie and thank you for telling me that my advice has helped! Regarding the chest lines and neck, yes I have my patients use tretinoin in these areas. It is important actually since the face/neck/chest are often seen in one vision when we wear many common types of shirts. The tretinoin works nicely to improve the appearance of the neck and chest skin. That said, those lines are often very deep and don’t budge a great deal but the skin texture and color improves which makes the lines less noticeable; bright and clear skin reflects light better so textural details are less apparent to the eye. It is important to know that a person’s ability to tolerate tretinoin on these areas will vary. Some people just can’t and it causes redness and irritation that never passes. Other people find it a breeze. I myself have used it on my chest and neck for 30ish years without any problem. Ideally I work my patients up to the 0.1% gradually. I think that waiting the 15+ minutes after skin has been wet matters here. Also, if one has night sweats and lots of fine skin folds that get sweaty that may make tolerance difficult. Again, this area often needs lots of encouragement to improve and resist aging. In addition to tretinoin, I also have my patients apply Glytone Body Lotion to the area twice a week if there is no retinoid dermatitis and if they can tolerate it without stinging. We BBL (IPL) the area routinely too and do superficial Profractional Laser Treatments. Our Skin Tyte treatments can help too. I personally avail myself of all-of-the-above and my 57 year old previously sun baked type II chest and neck looks ok for an old blond gal. It is work though to counter nature in this anatomic area. That’s the fun of it actually! Your question is so great I think I need to post it as an Ask Dr. Bailey. Thank you for your question!

  9. Tiana February 21, 2016 at 5:21 am #

    Hey Dr. Bailey

    Is it possible for you to write something about blackheads and how to get rid of them? I’ve tried a few techniques from this website http://www.nose-blackheads.com/ but I’m not sure if they are all good for my skin. Would love a doctors input on this.

    Tiana

  10. Cynthia Bailey, M.D. February 22, 2016 at 9:21 am #

    In very timely fashion we posted an article today about what happens during a facial and my aesthetician talks about how she cleans pores. http://www.drbaileyskincare.com/blog/from-the-aestetician-is-a-facial-a-treat-or-necessary-for-healthy-skin/ We can’t comment on the quality of content on another site or endorse it for any person’s particular skin issues. We can offer the information which we write according to our standards for educational purposes in our blog.

  11. Marie G. February 25, 2016 at 2:48 pm #

    I currently use Tazorac 0.05% cream directly on my skin after dabbing dry every night applying moisturizer about 20 minutes after and with every other night doing short contact therapy.I am trying to work my way up to every night without short contact therapy in between.(I use a cream hydrating cleanser). I have been doing this routine for about 3 weeks now before I would just apply 3 days a week applying moisturizer before application then moved to every other night applying moisturizer before application.(I have been using Tazorac for about 4 years). I haven’t experienced any bad irritation and it appeared to be working well and clearing my acne but however I have recently noticed small breakouts and my pores appear enlarged on my cheeks. Am I over using it? I’ve had that problem in the pass but when I over used it I would notice more large inflamed lesions and redness and currently that is not happening. I am also using a salicylic acid wash in the morning, maybe I should fallback on using that? So I am a little confused about what’s going on because I am not sure if the small breakouts and enlarge pores I have are from overuse or just normal?

  12. Cynthia Bailey, M.D. February 26, 2016 at 9:20 am #

    Hello Marie, These are good questions that only your treating dermatologist can answer; Tazorac is a prescription and the information on our website is educational, never intended as specific treatment for an individual.

  13. Stefanie Mendez March 1, 2016 at 9:04 pm #

    I began using Tretinoin .1% for my mild acne, prescribed by a new dermatologist. My face, mainly my mouth area, has been getting fairly dry and caused flakes. I then cut back and only applied it every other day with some improvement, but still have dry skin. I was wondering if you have any moisturizer you could recommend. I would prefer something that is not expensive but still effective. As well as over the counter or sold at a drugstore.

  14. Cynthia Bailey, M.D. March 2, 2016 at 7:32 am #

    Hello Stephanie,
    In my practice here are some of the products I find that my acne patients do well with http://www.drbaileyskincare.com/facial-acne-vulgaris-tolerant-skin.shtml We also use Replenix CF Cream to counter any dryness and help skin tolerate tretinoin. The cleanser used also needs to be more gentle when dryness is a problem. Eventually skin usually adjusts. I have written extensively on how to create skin care to support tretinoin usage as it is a very important topical medicine to help many complexion problems. You can use the search bar in the blog site to find more information if what I have given you here is not sufficient for your complexion needs.