Tretinoin is a prescription-only medication, also known as all-trans retinoic acid (ATRA)[1] commonly prescribed for the treatment of acne, fine lines and wrinkles, hyperpigmentation and sun damage. Retinoids and Retinol have risen in popularity over the years, piquing people's interest in it's derivatives and variants.
There has been a resurgence in online retailers selling the medication, allowing anyone to purchase it internationally. We’ve observed a significant number of purchases from South East Asia and similar regions. Whether this be Tretinoin, or Tazarotene (we'll have an article for this up soon.)
With that, we feel it's our duty to best educate the public on Tretinoin, what is it, its side effects, and how to use it for various skin conditions. As it stands, Tretinoin is NOT available through the NHS in the UK and will have to be prescribed and purchased through an online pharmacist.
Tretinoin vs. Retinol, What's the Difference?
Retinoids are a group of Vitamin A compounds. Tretinoin is the most potent, while Retinol is a milder alternative. The difference being that Tretinoin is an active form of retinoic acid synthesised in a lab, and therefore stronger.
Retinol on the other hand is converted into Retinoic Acid after contact with the skin, and is therefore less harsh.
For most skin concerns, Retinol should be sufficient. Stubborn acne and pimples, hyperpigmentation and sun damage can however be better treated with Tretinoin.
Benefits of Tretinoin for Skin
Tretinoin is often a last resort given the side effects, but it is an extremely effective medication and can help with:
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Treats stubborn acne
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Eliminates blackheads, whiteheads and closed comedones
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Fades and treats hyperpigmentation
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Minimises fine lines and wrinkles
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Boosts skin cell turnover
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Reduces dark spots
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Improves skin texture
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Evens skin tone
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Reduces inflammation and redness
It is without debate that this medication has helped millions worldwide with stubborn skin conditions, but it must be noted that it should be used with the advice of a licensed medical practitioner/dermatologist.
Step-by-Step Guide:
We'll have an article up with a skincare routine whilst using Tretinoin that we've found to work the best on various skin types. Until then, we advise you follow the guide below on how to use Tretinoin safely.
First thing to note is that Tretinoin will hugely increase sensitivity to sunlight, it is for this reason we advise staying out of direct sunlight whilst using the medication, or using a minimum of SPF factor 30 with broad spectrum (UVA + B) protection if you must venture out.
Apply Tretinoin only in the evenings. Start with every other day or 2-3 times a week, gradually increasing to daily use as tolerated. The concentrations it is typically available in is: 0.025%, 0.05% and 0.1%. If you're just starting off, use the lowest possible concentration.
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Cleanse your skin: This should form the beginning of any skincare routine. Make sure the skin is free of any impurities and makeup. Ensure no active acids were used on the day you're using Tretinoin either, as this can exacerbate peeling or aggravate irritation. Use a gentle cleanser.
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Wait 30 minutes: This is crucial to allow the skin to dry completely. If Tretinoin is applied on wet skin, absorption has the potential to increase and in turn worsening side effects.
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Use a pea sized amount for the whole face, and use the 13 dot method: A pea sized amount is generally sufficient for the entire face, and by dotting it all over before rubbing it in you'll ensure sufficient coverage. If you're unaware of the 13 dot method, you can read about it here at Harpers Bazaar: #SkinSchool: The 13 point skincare technique you need to try for better skin
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Wait another 20 minutes before following up with any serums or moisturisers: Tretinoin is drying for the skin and not moisturising can lead to or worsen peeling. We've found Cerave's moisturising cream to be the best moisturiser to use with Tretinoin; it is light but offers deep hydration with the addition of ceramides to maintain the skin's natural barrier. Keep things simple we say, try not to overuse products during this period so you can see exactly how your skin reacts.
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(Optional) Apply moisturiser before applying Tretinoin: If you're experiencing excessive sensitivity, redness or peeling, you can try the 'sandwich method'. This involves a thin layer of moisturiser prior to applying the medication, and then once again after applying the medication.
Precautions and Side Effects and How to Manage Them:
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Peeling is a side effect which should subside in 3-4 weeks. The skin is effectively sloughing off the outermost layer and during this period you should be extra careful with applying SPF and moisturisers.
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Results won't be immediate: As with Retinol, the results won't come overnight. You should begin to see a slight difference at around the three month mark, but most benefits are seen after a minimum of a year.
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Eye dryness is a commonly reported side effect. Make sure to not apply the medication near the periorbital area, as the skin is thinner and more susceptible to irritation.
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You may experience purging, this is when the skin appears to get worse, e.g. more acne and nodules and inflammation, prior to it calming down.
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Excessive dryness, irritation and redness, blistering or scabbing is a sign that something isn't going to plan. Ask a dermatologist if you experience any of these symptoms.
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Starting off with the lowest possible concentration and applying 2-3 times a week is the best way to ensure skin compatibility.
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Often Tretinoin is available in gel or cream form, but which is better? We advise using the gel form for acne sufferers as the cream form(s) can sometimes contain comedogenic ingredients depending on the retailer. Note that this is not always the case.
Frequently Asked Questions
How long before I see visible results?
Tretinoin results will be visible within 3-6 months, with the full benefits being achieved after one year.
Can Tretinoin be used everyday?
Tretinoin can be used daily, depending on skin tolerance we advise a maximum of 2-3 times a week to begin and working your way up to everyday.
What products should I not use alongside Tretinoin?
Stay away from active acids, AHAs (Glycolic Acid, Azelaic Acid, etc), BHAs (Salicylic Acid), Vitamin-C, Benzoyl Peroxide, along with any other physical or chemical exfoliants.
Can I use Tretinoin if I have sensitive skin?
If you have sensitive skin, we advise starting with the lowest concentration and trying the sandwich method to begin. If there is no further irritation, apply to clean, dry skin and monitor closely.
Can Tretinoin be used around the eye area and undereye?
We advise you exercise great caution as the skin in these areas is significantly thinner than anywhere else on your face. People have commonly reported dry eyes as a result also.
Can Tretinoin be used whilst pregnant?
Tretinoin should not be used during pregnancy, consult a dermatologist for alternatives.
What's the best moisturiser to use with Tretinoin?
Look for fragrance-free, hydrating moisturizers with ceramides and hyaluronic acid, such as CeraVe or Eucerin.
CeraVe moisturising cream is our favourite, followed by Eucerin Urea face cream.
Can I apply Tretinoin to my neck?
As with the eye area, Tretinoin can be applied to the neck. But exercise caution as the skin around this area is also thinner, we recommend applying it to your neck every other day, or 2-3 times a week.
What will happen if I stop using Tretinoin?
The benefits that Tretinoin provided depending on why you began using it in the first place will begin to fade. This may include acne returning, along with fine lines. If your skin had dark spots which are completely faded, these are unlikely to return if the culprit was sun damage.
How long does a Tretinoin purge last?
A typical purge should last for a maximum of 4 weeks, but depending on the severity of the issue this can last for 6-8 weeks.
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