Dermatologist guide: How to use tretinoin?
There is a big buzz about tretinoin, because of the many benefits it has for the skin, but how should you use it correctly to avoid the dreaded tretinoin burn and/or the tretinoin purge?
Table of Content:
When to apply it? | How much should I apply? | What strength should I use? | How long should I use it? | How to apply it? | How often should I use it? | Tretinoin burn | Tretinoin purge | Is tretinoin OTC? | Tretinoin alternatives
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Tretinoin is an effective solution if you are seeking to improve skin texture, reduce wrinkles and hyperpigmentation, and combat acne. In this article we asked Dr. Alpana Mohta, expert dermatologist about when you should apply it, how often, the strength you should start with, the amount you should use, and how to layer it in order to minimize skin irritation and other undesired side effects.
So, if you’re ready to dive into the world of tretinoin, we will help you gain a deeper understanding of how to use this prescription strength medication to achieve the clear complexion you desire.
If you’re interested in learning more about tretinoin, check out our guide All you need to know about tretinoin , which reviews the topic with insights from board-certified dermatologist Dr. Alpana Mohta, and our article What strength of tretinoin cream is best for wrinkles, acne and hyperpigmentation? featuring perspectives from Dr. Anna Chacon.
When should you apply tretinoin?
According to Dr. Mohta, you should always apply tretinoin at night. This is because when retinoids are exposed to sunlight, they can create harmful substances and excite retinoid molecules. These reactions can cause immediate and long-term damage in your skin1.
All About Tretinoin
Do you apply tretinoin all over your face?
Yes, Dr. Mohta says you should apply a very thin layer (pea-sized amount) of tretinoin to your entire face and neck.
How much tretinoin should I apply to my face?
Dr. Mohta says you should apply a pea-sized amount of tretinoin to the tip of your finger and touch several areas of your face leaving a tiny amount behind each time. After you have done this, distribute the tretinoin cream evenly over your face.
What tretinoin strength should I use first?
Dr. Mohta recommends you start with a low (0.01% or 0.025%) tretinoin strength so your skin gets used to the medication.
Considering adding a specific tretinoin strength to your skincare routine? Begin your journey here: Tretinoin 0.025% cream | Tretinoin 0.05% cream | Tretinoin 0.01% cream.
How to get a tretinoin prescription?
You can start a photo consultation with an online dermatologist to request a tretinoin prescription for acne or anti-aging. This is done via the Miiskin app. The process is very simple and it takes a few minutes.
A provider will evaluate your case and get back to you in one or two days’ time. You can collect your prescription at your local pharmacy the same day.
The price of a virtual consultation is $59 and you need to pay cash for it, however the price of your medication may be covered by insurance depending on your health plan.
How long should I use tretinoin for?
Dr. Mohta says that tretinoin can be used long term, even your entire life, as tretinoin is commonly used for the treatment of acne, fine lines, wrinkles, and hyperpigmentation.
Dr. Mohta, also says that it may be necessary to use tretinoin for a few weeks before you can notice changes in your skin. This is because the skin needs to adjust to the medication for the full benefits to become apparent.
What is the sandwich method of tretinoin?
The sandwich method involves washing your face with a mild cleanser, patting it dry with a towel and waiting 30 minutes. After this time you can then apply a layer of moisturizer, wait 10 more minutes, apply a thin layer of tretinoin and wait 10 more minutes to then apply a final layer of moisturizer or a hyaluronic acid serum.
Why wait 30 min after washing your face to apply tretinoin?
You need to wait 20 to 30 minutes before applying tretinoin to ensure your skin is completely dry. If you apply it ahead of time, you risk irritating your skin. Using a micronized version of tretinoin or Altreno can minimize the risk of irritation.
How often should I use tretinoin in the beginning?
These are some recommendations Dr. Mohta usually gives her patients:
- First 2 weeks: Apply low concentration (0.01% or 0.025%) two nights per week
- Following 2/4 weeks: Apply tretinoin 3 times per week or every other night
- After 6/8 weeks of use: If your skin tolerates the product well, apply the product every night
- After 12 weeks: After 12 weeks of using the product on a daily basis. You may be able to increase the strength of the product (0.04%, 0.05% and 0.1%). People with sensitive skin can benefit from using micronized formulations.
How long does it take for tretinoin to work?
Most patients using tretinoin for the first time will begin to notice a positive effect after approximately 10 weeks, if they are using it every 2-3 days. Learn a week by week process of how long does tretinoin take to work.
Should I use tretinoin every night?
You should aim to use tretinoin every night, however, you must start slowly as your skin needs to get used to it. The first 2 weeks apply it 2 to 3 nights per week, after that try applying it every other day, and then if your skin can handle it, apply it every night. However, skip a night or two if your skin is irritated, because it will make it worse.
treno which is much more gentle on the skin as its formulation includes: micronized tretinoin, collagen, hyaluronic acid and glycerin. In clinical trials this tretinoin version caused skin irritation to only 1% of patients using it6.
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Warning and precautions when using tretinoin
According to Dr. Mohta, you should always use a daily sunscreen SPF 50 when using tretinoin and reapply it every 2 hours when outdoors.
You should also avoid using too much of your tretinoin cream. You only need a pea-sized amount to cover your entire face. Using too much cream can increase your risk of experiencing side effects without offering extra benefits.
Do not do any dermaplaning treatments while using tretinoin. Do not wax or use chemical peels. Do not use tanning beds or expose yourself to the sun and use protective gear (sun hats, sunglasses and sunscreen) if you do and do not do any laser treatments while using tretinoin. All these things can increase your risk of increasing the side effects of tretinoin.
Retinoids cannot be used by women who want to get pregnant, are pregnant, or breastfeeding. Women of childbearing age should use effective contraception due to the teratogenic effects of retinoids. Tretinoin is approved for people 12 years of age or more and some of the micronized versions may be used by people 9 years of age or older.
Frequently asked questions about the proper use of tretinoin
What does tretinoin do after Accutane?
Dr. Mohta says tretinoin (a topical retinoid) can be a valuable part of your skincare routine after finishing an isotretinoin (Accutane) course, especially for maintenance and long-term skin health. Here’s how it can help:
- Preventing new breakouts: After completing a course of isotretinoin (Accutane), your skin may still experience occasional clogged pores or mild acne. Tretinoin can help maintain clear skin by increasing cell turnover, preventing the buildup of dead skin cells and oil, and keeping pores clear—thereby reducing the risk of blackheads and whiteheads.
- Fading post-acne marks and scars: Tretinoin is widely recognized for improving the appearance of post-acne discoloration and minor scarring. It helps fade dark spots by targeting hyperpigmentation and encourages collagen production, which can gradually improve the look of shallow acne scars and smooth the skin’s surface over time.
- Supporting long-term skin renewal: Beyond acne, tretinoin supports overall skin renewal. It enhances skin texture, evens out tone, and softens fine lines, contributing to a healthier, more radiant complexion. With consistent use, it can also serve as a preventative treatment for early signs of aging.
- Transitioning carefully: It’s essential to let your skin recover fully after Accutane before starting tretinoin. Because isotretinoin often leaves the skin dry and sensitive, dermatologists typically recommend waiting a few weeks before introducing tretinoin. Starting with a low concentration a few times a week, combined with good moisturization and daily sunscreen, can help ease the transition.
What is a tretinoin burn?
A tretinoin burn, also referred to as retinization, tretinoin irritation, occurs when you start using tretinoin and may cause symptoms like burning, dryness, peeling, redness, and flaking. Dr. Mohta suggests that these symptoms typically subside as your skin adjusts to the product. To treat a tretinoin burn, it is advised to stop using tretinoin until the symptoms cease. To soothe inflamed skin a cold compress and maintain a gentle skincare routine without makeup. Use a gentle, ceramide, propylene glycol, or hyaluronic acid-based moisturizer to help to rehydrate your skin. It will seal moisture so your skin can heal and will provide you relief from flaking and dryness.
What is the tretinoin purge?
Dr. Mohta says that the so-called tretinoin purge is a common skin reaction that occurs when a patient uses tretinoin for the first time. The symptoms often associated with this process include intensified acne breakouts (for a short period of 2 to 6 weeks), severe skin dryness and peeling, redness and irritation. However, this process is temporary and once it’s over, in general, the skin will improve, and you will be able to see the positive effects of tretinoin.
When to contact your healthcare provider?
Dr. Mohta says that you need to make sure that the symptoms you are experiencing are within the realm of what is “typical” as far as side effects go. Call your healthcare provider if your skin irritation is causing you severe pain or if it gets too uncomfortable.
How do you maximize tretinoin results?
To maximize the results of tretinoin, start slowly, apply tretinoin at night on perfectly dry skin and between two layers of moisturizer, wear sunscreen with SPF 50 every morning, and combine with niacinamide or hyaluronic acid to minimize irritation.
What cannot be mixed with tretinoin?
You should not combine tretinoin with any other retinoid. Unless indicated by your dermatologist, you should avoid using these ingredients at the same time or on the same day as tretinoin: benzoyl peroxide, lactic acid, salicylic acid, and physical exfoliants.
What cancels out tretinoin?
The effectiveness of tretinoin can be reduced by sun exposure as tretinoin is photosensitive, which means it degrades in daylight. A study shows that benzoyl peroxide in conjunction with light exposure reduced the effectiveness of tretinoin gel within 24 hours under specific lighting conditions up to 80%. If your tretinoin tube has not been stored properly or if it has been open for more than 6 months can also reduce efficacy of the medication.
What is best paired with tretinoin?
Tretinoin should always be paired with a moisturizer and sunscreen with a SPF 50. In addition to these two items, you can also pair it up with Vitamin C (applied before your sunscreen in the morning) and hyaluronic acid or niacinamide 10 minutes after applying your tretinoin cream.
Do I need to wash tretinoin off in the morning?
Yes, it is recommended to wash your face every morning before applying vitamin C, your moisturizer and sunscreen with SPF 50.
Can you put hyaluronic acid over tretinoin?
Yes, in fact it is recommended that you apply hyaluronic acid over tretinoin as this ingredient complements the effects of tretinoin due to its ability to attract and retain moisture in the skin. Tretinoin can cause dryness and irritation, especially in the beginning, so adding hyaluronic acid into your skincare routine can help minimize these side effects.
Tretinoin: What’s the difference?
Can I use vitamin C with tretinoin?
Yes, you can use vitamin C and tretinoin as long as you don’t apply them at the same time. You should apply tretinoin at night since it is photosensitive, and vitamin C in the morning after washing your face. When using tretinoin or vitamin C it is essential to apply sunscreen with SPF 50, even during winter, as these products make your skin more sensitive to the sun.
How to get a tretinoin prescription refill?
However, you can request a photo consultation with an online dermatologist to request a tretinoin prescription for acne or anti-aging. he price of a virtual consultation is $59. You will get an answer in 1-2 business days and you can collect your prescription at your local pharmacy the same day.
Is it possible to use tretinoin for anti-aging?
Yes, it is possible to use tretinoin to reduce fine lines, wrinkles and photoaging.
Who should avoid tretinoin?
Tretinoin must not be used by women who are pregnant, nursing or wish to become pregnant. In addition to that, tretinoin should also not be used by children under 12 years of age (this depends on the brand and product concentration) or by individuals with active flare of rosacea.
Can you use tretinoin if you have sensitive skin?
Yes, it is possible to use tretinoin even if you have sensitive skin or rosacea.
When to contact your healthcare provider?
Dr. Mohta says that you need to make sure that the symptoms you are experiencing are within the realm of what is “typical” as far as side effects go. Call your healthcare provider if your skin irritation is causing you severe pain or if it gets too uncomfortable.
Lee el artículo en Español: ¿Como se usa la tretinoína?
References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5574737/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699641/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7039055/
https://my.clevelandclinic.org/health/treatments/23293-retinol
https://www.altreno.com/
https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/tog.12075#
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4025519/
https://www.medicalnewstoday.com/articles/323628
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