Understanding tretinoin cream 0.05%: Uses, benefits, and how to get it

Table of Content:
Brands | Prescription | How is it different? | Benefits | How to use it? | Ingredients to combine it with | Ingredients to use caution | Precautions | Side-effects | The purge

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What is tretinoin 0.05% cream and what is it used for? 

Tretinoin cream 0.05% is a medium-potency topical prescription medication known for its effectiveness in improving skin texture and tone. Tretinoin cream 0.05% is used for the treatment of:

• Severe melasma (in combination with hydroquinone)
• Acne
• Acne scars
• Post-inflammatory hyperpigmentation
• Wrinkles 
• Smooth skin texture

What are the brands you can find tretinoin 0.05%? 

• Altreno lotion 0.05%
• Atralin cream 0.05%
• Refissa cream 0.05%
• Retin-A cream 0.05%

Do you need a prescription to buy tretinoin 0.05% cream?

Yes, you need a doctor’s prescription to get tretinoin 0.05% which means you should have a consultation with a licensed healthcare professional.

How can you get a prescription for tretinoin 0.05% cream?

You can have a photo-consultation with an online dermatologist through Miiskin. You need to pay $59 for the virtual photo-consultation and $39 for the medication renewal (which is usually needed after 3 months.)

How is tretinoin 0.05% cream different from other tretinoin strengths?

Tretinoin 0.05% is considered medium-strength, making it suitable for individuals who have used lower-strength tretinoin or for those with a more severe skin problem. Compared to lower concentrations, it offers:

• Faster results: Potentially more noticeable improvements in skin texture and appearance.
• Increased effectiveness: Enhanced ability to address acne, fine lines, wrinkles, and hyperpigmentation.
• Stronger side effects: Higher likelihood of irritation, dryness, and sensitivity.

Tretinoin 0.05% is usually prescribed for individuals who have already used and gotten used to lower-strength tretinoin products. If you get a prescription, for tretinoin 0.05% but it is too irritant for your skin, talk to your dermatologist about switching to tretinoin cream 0.025% or request a compounded tretinoin formulation with hyaluronic acid or niacinamide to help sooth your skin and prevent dryness. 

Benefits of tretinoin 0.05% cream

• Diminishes the appearance of fine lines and wrinkles
• Repairs skin damage caused by sun exposure
• Improves overall skin texture
• Promotes a more even skin tone
• Helps reduce breakouts
• Provides anti-inflammatory effects

How to start using tretinoin cream 0.05 %?

Initial weeks (Weeks 1-4)

• Moisturize: Begin by applying a hydrating cream with ingredients like hyaluronic acid or niacinamide. Wait 10 minutes for the moisturizer to absorb.
• Apply tretinoin: Use tretinoin cream 0.05% two nights per week. After applying tretinoin, follow up with another layer of moisturizer.

Intermediate phase (Weeks 5-10)

• Increase frequency: Gradually increase the frequency to every other night. Continue the routine of applying a moisturizing cream, then tretinoin, followed by another layer of moisturizer.

Long-term use (After 12 Weeks)

Daily application: If your skin tolerates the product well, use tretinoin cream 0.05% every night. Apply it using the “sandwich method”: first apply a moisturizer, then tretinoin, and finish with another layer of moisturizer.n include niacinamide and/or hyaluronic acid. In fact, this is a popular formula preferred by many. Just mention during your photo-consultation that you would like to have a customized tretinoin formula by Skin Medicinals.

What ingredients can be used alongside tretinoin 0.05%?

You probably know that you can use tretinoin alongside hyaluronic acid and niacinamide, but did you know that there are other ingredients that can complement your skin care routine alongside tretinoin?

• Ceramides: Help to restore the skin barrier and lock in moisture, which can alleviate dryness and irritation caused by tretinoin. 
• Peptides (Matrixyl and Argireline): Support skin repair and collagen production, which can complement tretinoin’s anti-aging effects.
• Squalane: Protects the skin against free radicals (such as pollution UV radiation stress) and it helps reduce oxidative stress preventing damage in the skin.

What ingredients should be used with caution when also using tretinoin 0.05%?

• Hydroquinone: While hydroquinone is considered the golden standard to treat hyperpigmentation alongside tretinoin, this combination can cause additional irritation, therefore it should be introduced gradually if used together.
• Benzoyl peroxide: While tretinoin and benzoyl peroxide are both effective acne treatments, benzoyl peroxide can degrade tretinoin unless combined in the same formula (Twyneo). If both are prescribed, it’s best to use them at different times of the day (for example, use benzoyl peroxide in the morning and tretinoin at night).
• Salicylic acid: This is a beta-hydroxy acid that can also increase skin sensitivity and irritation when combined with tretinoin. If you use both, use them on alternate days. Glycolic or lactic acids:These alpha hydroxy acids can also cause excessive dryness, peeling, or irritation when used with tretinoin. Use them on alternate days.
• Vitamin C: An antioxidant that can brighten the skin, boost collagen production and reduce hyperpigmentation but it can cause irritation when used alongside tretinoin. Use in the morning, before applying sunscreen as it will help protect your skin against anti-oxidant stress.
• Physical exfoliants: Scrubs can increase skin irritation, redness, and dryness when used alongside tretinoin. It’s best to use gentle, non-abrasive products.
• Alcohol-based products: Toners or astringents with high alcohol content can cause excessive dryness when combined with tretinoin. Opt for alcohol-free, hydrating products.

Can I get a customized tretinoin 0.05% formula?

Yes, the board-certified dermatologist available through Miiskin can prescribe you a customized tretinoin 0.05% formula designed for your needs via Skin Medicinals. For example: tretinoin + niacinamide for sensitive skin or tretinoin + hydroquinone for hyperpigmentation.

Precautions when using tretinoin 0.05% 

Women using tretinoin creams and gels are strongly advised to use effective contraception during treatment. Tretinoin is classified as teratogenic, making it unsafe for women who are pregnant, planning to become pregnant, or breastfeeding due to its significant risks to a developing fetus.

Tretinoin 0.05% increases the skin’s sensitivity to sunlight. Therefore, it is essential to apply sunscreen with at least SPF 50 every morning and reapply it every two hours when exposed to sunlight.

This medication should only be used under the guidance of a qualified healthcare professional.

Potential side effects of tretinoin 0.05 % 

The most evident side-effect tretinoin 0.05% has is peeling and dryness, particularly if this is your first time using retinoid. However, you can also experience the following symptoms:

• Irritation and dryness
• Increased sensitivity to the sun
• Temporary worsening of acne (Tretinoin purge)
• Redness and peeling
• Stinging or burning sensation

Can tretinoin 0.05% cause a purge even if you have used a lower tretinoin strength before?

According to Dr. Howell, tretinoin 0.05% can still cause a purge even if you’ve been using tretinoin for some time. The “purge” can occur when increasing the concentration of tretinoin, as the higher strength accelerates the skin’s exfoliation process. This might temporarily worsen acne or cause new breakouts as accumulated debris and impurities are expelled from the pores. Despite this initial flare-up, the purge typically resolves and can lead to clearer, smoother skin as your skin adjusts to the higher concentration.

The tretinoin purge is usually a temporary phase and the duration can vary between a few weeks to several months, depending on individual factors. It is generally advisable to adhere to the prescribed treatment regimen as the skin typically demonstrates improvement once it has adapted to the medication.

References:
¹https://www.ncbi.nlm.nih.gov/books/NBK557478/
²https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9112391/
³https://link.springer.com/article/10.2165/00002512-199506060-00008
⁴https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3225141/
⁵https://pubmed.ncbi.nlm.nih.gov/16045694/
⁶https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3225141/
⁷https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9112391/
https://www.ncbi.nlm.nih.gov/books/NBK539693/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605218/
https://pubmed.ncbi.nlm.nih.gov/12553851/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6981886/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6253993/

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