How To Correctly Use Retin A Tretinoin For Anti Aging and Acne Skin Care

Cynthia Bailey, MD|June 4, 2010

 

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." Dr. Cynthia Bailey

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 for anti aging) 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.

tretinoin for anti aging Dr. Bailey's tube

My tube of tretinoin sitting on my bedside table

Additional treatment tips to help skin tolerate tretinoin for anti wrinkle 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 my Calming Zinc ® Soap. Many cleansers are too irritating for tretinoin treated skin. 

calming zinc soap tretinoin for anti aging toleriane cleanser

  • 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!
  • Replenix CF CreamAnother 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.                                        

"My face is so much less red than it used to be. Plus, when I used to get out of the shower my face would be scaly, now it's soft! The Clarisonic (Clarisonic Smart Profile and Clarisonic Mia 2) is great and it helps the Replenix work even better than before." Sheila W

  Important things to know about tretinoin for anti aging 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.
  • dermatologist recommended sunscreenAnyone 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 has served me well. 

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 anti aging 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 tretinoin and Retinol Anti Wrinkle information helpful, you may want to read:

Photo Copyright © Dr. Bailey Skin Care LLC.

Hi Dr. Bailey!

I took your advice and purchased the Toleraine cleanser and the Replenex serum to lessen the irritation from Retin A. I love both products and will repurchase them in the future. I am using the Toleraine cleanser after work then following with the Replenix and a bit of a neutral moisturizer around my nose/mouth for the dryness.  I wait a couple hours and use the Retin A just before bed. Is this routine affective? Is it ok that I’m using the Replenix before the Retin A?
Thanks for your response!
Jen

By Jen on 2016 09 22

Does tretinoin come in different strengths? What is the correct concentration to use? Thanks smile

By Narelle on 2016 09 25

Is anything for hands ? like loose skin ?

Regards

Seema Sarwar

By Seema Sarwar on 2016 10 03

Hello Jen, Narelle and Seema,
Tretinoin (Retin A) comes in 3 strengths and I start my patients on lowest and move up. I also have them apply products such as Green Tea or Replenix before tretinoin. Use of moisturizers is also common in my practice and results are good. This routine can be used on hands too though sun protection must be carefully used all day and it is more difficult on hands than the face. Warm Regards

By Cynthia Bailey, MD on 2016 10 06

Hello,  I wanted to know if I can apply my facial oil before the tretinoin or should I apply afterwards.  Thank you.

By Vivian Alfonso on 2016 10 13

  I’ve been using a light coat of coconut oil after applying the Retin-A . So far my skin is not peeling though I’ve only been doing this routine for two weeks.

By Shirley on 2016 10 19

Hi Dr, Bailey,
Love your blog and all the wonderful advice! Three questions for you pls. I’ve purchased the Stieva-A Tretinoin cream at 0.05%. There is a supposed shortage in Tretinoin right now and the 0.1% wasn’t available in cream form. (1.) Is the Stieva-A Tretinoin product equal to the one your recommend in efficacy? I wanted the cream form because I was afraid the gel would overly dry out my skin. I have oily yet dehydrated skin, with a tendency for breakouts even though I’m 40. However, it seems that my skin is getting oilier with the Tretinoin use (about 3 weeks now) and my breakouts have increased. (2.) Could this be due to the “white petrolatum” ingredient in the Stieva-A blocking my pores? Debating wether to switch over to the gel form, but worried the drying out might age my skin. (3.) How long before a sun holiday, microdermabrasion, or laser treatment, should I refrain from my Tretinoin use? Your advice would be greatly appreciated. Thank you so much!

By Denise on 2016 10 20

Hello, I have been using tretinoin for almost a year now. I started with 05% and now I use 1% in cream or gel. At first I noticed a difference but now I see lots of little lines all over my face, I have olive skin and had miner lines around eyes and lips. But the lines now are everywhere. I am 62 but my skin was nice. Could the tertinoin making it worse or will it improve. looking forward to hear from you regards Maria

By Maria on 2016 10 20

I was wondering if I can still use a salicylic based face wash along with a clarisonic while treating my skin with tretinoin.

Also, about four months ago I made the mistake of using too much tretinoin and getting chemical peels at the same time. This gave my face an orange peel texture. The texture had improved. Do you think correct usage of tretinoin would improve the texture further?

By Elizabeth on 2016 10 23

Hello Elizabeth,
I have patients use sal acid and tretinoin in complete skin care routines all the time. That said, as tretinoin is rx, only your prescribing doctor can say if the combo is right for you. Tretinoin does improve skin texture when used on skin that is not damaged. I always allow sufficient time for skin to heal after an injury. This could be as much as 6 to 8 weeks.

By Cynthia Bailey, MD on 2016 10 25

Hello Maria,
The tretinoin usually works nicely to slow skin aging but it won’t totally stop it. Also, if irritation, dryness or retinoid dermatitis develops then there may be lines from that. The trick is to figure out if that is the case. That’s why I use the mild cleanser and hypoallergenic skin care products with Tretinoin as mentioned above as well as sunscreen with zinc oxide.

By Cynthia Bailey, MD on 2016 10 25

Hello Vivian and Shirley, I let patients decide if they want to apply a moisturizer before or after tretinoin. We then look to see if the tretinoin is able to improve appearance of the skin still to determine if we think this is helping or impeding tretinoin performance for the complexion. I personally put a moisturizer on before I wait my 15 or 30 minutes prior to applying tretinoin. Everyone’s complexion balance is different.

By Cynthia Bailey, MD on 2016 10 25

Hello Denise,
The petrolatum can make the skin feel oily but should not increase oils. It is also not considered comedogenic. Retinoids have been associated with microcomedones coming out and that can cause a breakout, but it is also possible that the breakout is unrelated. I don’t have experience with Stevia A formulation of tretinoin. It is not the same as Retin A or Renova base and our generics are copies of the original bases. Gels are more drying and not tolerated by many complexions. Oily skin complexions prefer the gel however. Recommendations for stopping tretinoin vary based on the procedure from 1 week to 2 months. Best to ask your doctor because skin is more sensitive to waxing and other procedures when on tretinoin and scarring or post-inflammatory redness or pigment may result.

By Cynthia Bailey, MD on 2016 10 25

Hi,
    I am using Peter Thomas Roth Retinol Fusion PM 1.5%  and never experienced redness or flaking. I just don’t like the product being so watery so thinking about starting on retin-A.  With what dosage should I start?

By Melanie on 2016 10 26

Hello Melanie,
Retin A is prescription so that question needs to be posed to a treating physician when obtaining the prescription. As mentioned above, in my practice, I start my patients on the lowest 0.025 and we slowly work up as the skin adjusts.

By Cynthia Bailey, MD on 2016 10 30

Hi Dr, I am 40 years old from Egypt . I want to ask how long do I have to use Retain a cream 0.25. Do I have to use it 3 months continuous then stop 9 months? Or I can use it The Whole year twice a week . Thanks a lot

By Eman on 2016 11 01

I’ve been using tretinoin on and off since I was a teen and I’m now 36 and would like to use it regularly.  I wear sunscreen daily, either Citrix or Elta but my concern is sun safety since I live in Texas and spend a lot of time outside with my boys, especially during the summer.  What is the safest way to use tretinoin continuously and remain sun safe, especially during summer months.  Should I use a lower strength, less frequently, or just reapply sunscreen more frequently? Thanks so much for your blog and wealth of information!

By Bree on 2016 11 10

Hello,  I want to make sure that you can use the retin a nightly ( forever) and dont need any other products at night.  I do have a daytime creme, but Just want to make sure retin a is all I need>?

By sherry on 2016 11 17

also,  This is not used under the eyes?

By sherry on 2016 11 17

Hello Sherry,
This is a prescription medicine so only a person’s treating physician can determine if it is the only night treatment needed. That said, I have many patients who use tretinoin as the sole treatment for a variety of appropriate skin problems.

By Cynthia Bailey, MD on 2016 11 22

Add Your Comment