How To Correctly Use Retin A (Tretinoin) For Acne & Anti-Aging Skin Care

Do you know that tretinoin, the active ingredient in Retin A, breaks down in sunlight?

And, do you know that if you apply it to moist skin, it’s more likely to cause peeling and skin irritation?

Lastly, do you know that some of the common and really good ingredients in other skin care products aren’t compatible with tretinoin?

Used correctly, tretinoin does amazing things for skin. I love tretinoin and have personally used it for over 25 years. My skin looks better now than it did then. I’ve also written thousands of prescriptions for it in that same period of time and I’ve helped the same number of patients integrate it into their skin care treatments.

Just this last month I had interesting conversations with two of these patients, both of whom expressed gratitude for my recommending tretinoin and attributed the healthy condition of their skin to their years of tretinoin skin therapy:

The first patient is a woman in her early 60s with rosacea and a history of skin cancer who said that she had more wrinkles 15 years ago when she started using tretinoin than she does today. Her pores appear smaller and her skin texture is better, and she feels it’s the tretinoin that’s helped.

The second patient just turned 39 and looks like she is in her mid-twenties. She started using tretinoin at 27 and says she, too, looks better now than she did then. While getting a pedicure to celebrate her birthday, the woman giving her the pedicure was astonished when she found out that my patient was over 30.

Tretinoin therapy is well worth the effort in my opinion, but there are tricks to doing it right.

The three key tricks I tell my patients for using Retin A (tretinoin) correctly

  1. Always apply it to your skin at bedtime, never use it during the day.
  2. Never apply it at the same time you also have products on your skin that contain glycolic acid or benzoyl peroxide .
  3. Always wait at least 15 to 30 minutes after washing your skin and applying any other skin care products before you apply tretinoin. I personally keep my tube of tretinoin on my bedside table and read a little to pass the time before I apply it.

My tube of tretinoin sitting on my bedside table

Additional treatment tips to help skin tolerate tretinoin therapy

  • Start tretinoin therapy by using the product twice a week (every third night) and slowly increase to every night over a month or two as your skin adjusts. A little scaliness and irritation is normal at first, but if the treated skin becomes really sensitive, back off and wait. Let the skin return to normal then begin treatment again. Slowly try to increase to every night as your skin adjusts.
  • Apply a ‘pearl-sized’ portion to the face. Use the same amount for the neck and/or chest.
  • If your skin continues to become irritated and just won’t adjust to tretinoin treatment, then switch to entirely non-irritating cleansers like Toleriane Cleanser or Calming Zinc ® Soap. Many cleansers are too irritating for tretinoin treated skin.  Click here to see Tolariane Cleanser toleriane cleanser best cleanser with retin aClick here to see Calming Zinc Soap calming zinc soap
  • If your skin becomes red and irritated for any reason (eg. wind burn, sun burned, harsh skin care products, surgical or cosmetic procedures etc.), don’t apply tretinoin until your skin has entirely returned to normal. This is because tretinoin irritates irritated skin!
  • Another trick is to also use an anti-inflammatory and soothing product like Replenix CF Cream.  I’ve found that the high concentration green tea antioxidants combined with caffeine in this product help my patients adjust to and tolerate tretinoin better.  Sometimes just adding Replenix CF Cream creates all the difference between a positive and a troublesome experience with this great medicine. Apply it twice a day after washing and apply your other skin care products on top.  Click here to learn more about Replenix CF Cream Replenix CF Cream

Important things to know about tretinoin treatment

  • Tretinoin-treated skin is very exfoliated and should not be waxed for hair removal.
  • Any doctor or skin care specialist performing a procedure such as a chemical peel, microdermabrasion, laser or light treatments etc. needs to know you are on tretinoin. They may ask you to stop it for a period of time before and after your treatment.
  • Anyone who is or may be pregnant should not use tretinoin.
  • Anyone using tretinoin must sun protect their skin or they will have more skin sun damage than if they never used tretinoin, again because tretinoin skin is very exfoliated.  That means that if you use tretinoin, you should wear a really good sunscreen everyday on your treated skin.  I think the mineral zinc oxide sunscreens give the best sun protection.  My favorite is Citrix and I’ve worn it everyday for all these years that I’ve used tretinoin.  It’s oil free, is invisible on the skin and it’s served me well.  Click here to see Citrix Sunscreen dermatologist recommended sunscreen

Lastly, why bother with this tricky and sometimes inconvenient skin care treatment?

Scientific studies and my medical experience give me so many reasons to be a big fan of tretinoin:

  • It has proven itself to reduce, reverse, and prevent wrinkles. The younger a person starts (teens and twenties), the more benefit they receive, but it’s never too late!
  • It helps lighten and prevent age spots.
  • It builds collagen to thicken and increase the structural strength of treated skin.
  • It helps to decrease a person’s risk of developing skin cancer.
  • Skin just looks better and younger when they use tretinoin.

I’ve used tretinoin for over 20 years and will continue to do so. I see the benefits every day in the mirror and for me these benefits outweigh the inconveniences. How about you? What are your stories?

If you found this information helpful, you may want to read:

5 Steps For Smart Sun Protection

How To Get The Most Out Of Your Anti Aging Skin Care

How To Unclog Your Clogged Pores

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3 Responses to “How To Correctly Use Retin A (Tretinoin) For Acne & Anti-Aging Skin Care”

  1. Robin June 6, 2010 at 2:30 pm #

    Great information! Couple of questions though.

    First, what strength do you recommend. I’ve heard that 0.05% is the best strength for anti-aging but I’m interested in your opinion on this. I have both the 0.05% and the 0.1%. Second, do you put it all over?

    Thanks Dr. Bailey!!!

  2. Cynthia June 7, 2010 at 7:34 am #

    Hello Robin,
    These are good questions and one’s I’m often asked by patients. I explain to them that tretinoin cream comes in 3 strengths: 0.25, 0.05 and 0.1. The cream works best for photoaging and so it’s what I recommend.. I always tell patients to start on the the lowest strength and then work to the highest that they can tolerate. This may be the higher concentration on some areas of the face, but a lower strength on others. For example, the skin around the nose may be more sensitive and not tolerate the higher 0.1 strength, but the rest of the face can, and so I then would recommend ‘mix and match’ to use the highest strength an area can handle. It’s not uncommon to have 2 strengths at home and put the lower on some areas and the higher on others. Also, there are times when skin is just more sensitive and dropping down a strength level is necessary, so again, having 2 strengths on hand is useful.

    Tretinoin for photoaging and acne is to be applied to the entire area to be treated, meaning it goes on the entire face, neck and chest if those are the treatment areas. It’s not a medicine that works well as a spot treatment because the benefits are developed over time.

    Thanks for really good questions that fill in some practical pieces of information.
    Warm Regards, Cynthia Bailey MD

  3. Robin June 7, 2010 at 10:52 am #

    Thanks Dr. Bailey! This is incredibly helpful.
    I have 2 strengths and as you’ve said there are times when I’ve experienced some irritation in just one area. For some reason my chin seems to be super sensitive. I’ve ended up lowering the strength on my whole face but it never occurred to me to “mix and match” the strengths – using a lower strength on some areas and a higher strength on other areas. I will try this for sure! My forehead lines which can tolerate the 0.1% will apprecaite it! :)