Dr. Carin Litani Dr. Carin Litani Apr 30, 2020

Why Aren’t You Using a Retinoid?

Who isn’t using tretinoin, or retin-A, or adapalene, or tazorac? Why aren’t you??!? It’s the best anti-aging topical out there! Seriously …

I think everyone, men and women, should be using this throughout their lives. Only stop or take a break if you are a woman trying to get pregnant, are pregnant or are breast-feeding. Teens can even use this to help clear up acne.

Dermatologists have been prescribing tretinoin since the 1960s. But the discovery that it can be used to treat wrinkles and improve the appearance of aging skin is relatively new beginning in the 80s.

I like to think of how tretinoin works by pretending the skin is a classic New England roof suffering from several snow and ice storms … shingles out of place, some damaged, some piled on top of one another, with tree branches and moss everywhere. Tretinoin slowly converts this damaged roof to a beautifully stacked Spanish colonial tiled roof. The top layer of skin is removed of all its sticky and clogging cells. The skin is more radiant, smooth and even. Tretinoin then penetrates even deeper to stimulate collagen production and keep the skin tight and youthful!

Yes, it can be drying and some people are more sensitive to that. Here are some tricks on how to use it:
  • Start with an over the counter retinol which is weaker than the prescription version or with OTC differin 0.1% lotion. Think of it as a primer. Once your skin is primed, ask your dermatologist for prescription strength tretinoin.
  • Start with a low strength tretinoin and work up to the strength that isn’t too drying. For example, I use tretinoin 0.05%. I start most of my patients on 0.025%. Some stay on this while others can go up after months to years. I find that only people with very oily skin are the ones that can handle 0.1% or even tazorac.
  • Start 1-2 nights a week and work up to every other night or nightly.
  • Apply a nice hydrating moisturizer immediately on top of the tretinoin or mix it together before applying.

It is normal to experience mild scaling (like dandruff of the skin) for a few weeks after starting the treatment. This shall pass. You must get through this dry phase. It’s re-tiling that roof! Just apply more moisturizer throughout the day and skip a night of application.

Please be aware that it is not normal to experience redness, itching, swelling, or peeling like a sunburn. Let your doctor know if you have any of these symptoms.

You should cease Tretinoin for 5-7 days before any waxing procedures, chemical peels, or laser treatments. Confirm this with your aesthetician or dermatologist.