Tretinoin and benzoyl peroxide combined

Table of Content:
Can I use them tretinoin and benzoyl peroxide together? | How to get a prescription? | How to use them? | What results can I expect? | Side-effects | Long-term use | Brands

The combination of benzoyl peroxide and tretinoin tends to be quite effective for moderate to severe acne¹. This article explains the benefits and mechanisms of action of this potent combination and helps you get a prescription for benzoyl peroxide and tretinoin.

Tretinoin (commercially known as Refissa, Retin-A or Altreno) is a widely prescribed retinoid in dermatology. Tretinoin promotes the growth and turnover of skin cells, accelerates the removal of older skin cells and encourages the generation of fresh ones. It also helps unclog pores, reduce inflammation, and improve the overall skin texture. Tretinoin is available as a cream, gel or lotion and it comes in many different strengths².

If you want to learn more about tretinoin, we recommend you take a look at Tretinoin: A dermatologist’s guide for patients by Dr. Alpana Mohta.

Benzoyl peroxide is commonly used in the treatment of acne, it works by killing the bacteria that contribute to the development of acne and by helping to unclog pores. It also has a mild drying effect on the skin, which can help reduce excess oil production. Additionally, benzoyl peroxide can have an exfoliating effect on the skin, helping to remove dead skin cells and promote the growth of new, healthy skin³. 

Benzoyl peroxide is available in both over-the-counter and prescription-strength formulations, with concentrations typically ranging from 2.5% to 10%; it also comes  in various formulations, including creams, gels, and washes.

Can I use benzoyl peroxide and tretinoin together?

Yes, you can use them together as two separate ingredients or as a combined formula. However, since tretinoin is not an over the counter medication, you should only use them under medical supervision in acne treatment. 

How to get a tretinoin and benzoyl peroxide prescription?

You can get a prescription for a tretinoin and benzoyl peroxide formulation by having a virtual photo-consultation with a dermatologist. Price of the consultation starts at $59 and it takes 1-2 days to get an answer. 

If the dermatologist considers this medication is adequate for you, you will get your prescription. You may also get another prescription (such as tretinoin and topical spironolactone or tretinoin and clindamycin) if they think it is most suitable for your type of acne. 

Should I apply benzoyl peroxide or tretinoin first?

If you are using two separate medications, you should apply benzoyl peroxide in the day time and tretinoin at night.

How to use benzoyl peroxide and tretinoin together?

Benzoyl peroxide and tretinoin can be used together in a skincare routine to address different aspects of acne. However, it is essential to use them carefully to minimize potential irritation. Here are some guidelines for using benzoyl peroxide and tretinoin together:

Start slowly

When incorporating these two products into your routine, it is best to start slowly to allow your skin to adjust. Begin with one of the products and use it every other night or every third night to see how your skin reacts.

If you are using two separate medications

If you are using two separate medications, you should apply benzoyl peroxide over the affected areas in the morning followed by sunscreen with a high SPF factor. You can use a cleanser, cream, or gel.

Tretinoin is always applied at night since it is sensitive to light. Apply it on clean, dry skin and use a pea-sized amount to spread it evenly over your face. It is also important to know that you should never apply these creams on damaged or injured skin.

Read our dermatologist guide that includes a step-by-step guide on how to apply tretinoin to minimize skin irritation.  

If you are using a compounded medication

If you are using a compounded medication, you should apply it at night after washing your face and applying a gentle, non-comedogenic moisturizer.

Use sunscreen

Both benzoyl peroxide and tretinoin can make your skin more sensitive to the sun, so it is essential to use a broad-spectrum sunscreen with SPF 30 or higher during the day, even during winter or if you spend most of your time indoors.

Use a moisturizer

Both benzoyl peroxide and tretinoin can be drying and irritating to the skin. To protect your skin against excessive dryness, use a gentle, non-comedogenic moisturizer to keep your skin hydrated. Apply it in the morning and evening.

Monitor your skin for irritation

Pay close attention to how your skin reacts. If you experience excessive redness, peeling, or irritation, reduce the frequency of one or both products or consult your dermatologist for guidance. They may suggest adjusting the strengths or formulations of the products.

Remember that using both benzoyl peroxide and tretinoin together can be effective, but you need to use them carefully and under the guidance of a healthcare provider to minimize side effects and achieve the best results for your skin.

What results can I expect from using a benzoyl peroxide and tretinoin gel?

Less acne breakouts

Since they have very different mechanisms of action, together, benzoyl peroxide and tretinoin will help you reduce acne breakouts, and unclog pores, kill acne-causing bacteria, and promote the shedding of dead skin cells, which can lead to fewer breakouts over time^{4 5} .

Reduced inflammation

Both benzoyl peroxide and tretinoin have anti-inflammatory properties^{6 7} . They can help decrease the redness and swelling associated with active acne lesions, making your skin look less inflamed.

Reduction of oil production 

Benzoyl peroxide and tretinoin can also help reduce excess oil production, which can contribute to acne. By controlling oiliness, you can experience fewer breakouts^8 9 .

Improved skin texture

Tretinoin is known for its ability to improve skin texture. It promotes cell turnover, which can help fade acne scars, reduce the appearance of fine lines and wrinkles, and make your skin look smoother and more youthful¹⁰.

Potential side effects of using benzoyl peroxide and tretinoin together

• Dryness and peeling
• Skin irritation 
• Burning or stinging 
• Itchiness
• Sensitivity to sunlight
• Initial acne flare up (the so-called tretinoin purge)
• Increased sensitivity to other ingredients
• Allergic reactions¹¹

Can I use benzoyl peroxide and tretinoin long term?

The long-term use of benzoyl peroxide and tretinoin for the treatment of acne can be safe and effective for many individuals, but it should be done under the guidance of a healthcare provider or dermatologist. However, after your acne improves, your dermatologist may consider switching to a tretinoin and niacinamide prescription which is less irritating than the combination of tretinoin and benzoyl peroxide.

References:
https://pubmed.ncbi.nlm.nih.gov/36639853/
https://www.ncbi.nlm.nih.gov/books/NBK557478
https://www.ncbi.nlm.nih.gov/books/NBK537220/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5574737/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605215/
https://pubmed.ncbi.nlm.nih.gov/17309452/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699641/
https://my.clevelandclinic.org/health/drugs/23704-tretinoin-benzoyl-peroxide-topical-cream

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