Hi everyone! Today I want to talk to you about a topical treatment that I’m obsessed with: and it’s tretinoin. Tretinoin is something that’s becoming increasingly popular and you might have seen a lot more about it in magazines, but it’s basically from the family of retinoids.
These are derivatives of vitamin A and the most famous members of that family are retinol and tretinoin. I’m going to chat with you about what they are, why they’re good for your skin and how to decide which is best for you.
Retinol, which most people are much more aware of, is the kind of natural form of vitamin A. This is a vitamin that we know topically, vitamin A and its derivatives when they’re applied to the skin, they have been shown in clinical studies to reduce lines and wrinkles, to be beneficial in reducing inflammation, breakouts and acne, and they have been shown to improve over time the texture of the skin, and to help with hyperpigmentation and sun damage. Tretinoin is a synthetic derivative of vitamin A, it is stronger, and it’s, as a result, prescription only.
So, you need to find an aesthetic doctor or a dermatologist who can prescribe it and dispense it for you.
So, why are vitamin A and its derivatives important? Well, the main thing that I mentioned, they’re one of the few skincare ingredients that we know can help reduce the appearance of fine lines and wrinkles and prevent them from coming on. So, from an anti-skin ageing perspective, they’re useful. It’s something that you can do at home, you can integrate easily into your skincare routine.
With regards to retinol, there are so many over-the-counter formulations that are available. From a tretinoin perspective, it works a little bit faster and it’s a little bit deeper with tretinoin, it’s great if you’ve already got lines and wrinkles and you’re looking to reduce them and prevent new ones. Both of these, but particularly tretinoin, tretinoin is licensed for use in acne. So if you suffer from acne breakouts, if you’ve got a texture and scarring, then tretinoin is great for helping with all of these.
In that situation actually, it’s better than retinol, if you have ongoing acne that you’ve struggled with for some time.
Sun damage, pigment, dark spots from being exposed to the sun, melasma, things like hyperpigmentation, so again especially post-inflammatory hyperpigmentation if you get acne breakouts and then once they’ve kind of broken out, you might get dark areas where they were, tretinoin is good for helping fade with these; retinol as well, but again, it just takes longer to work and it doesn’t work as deeply. The mechanism of action for both of these is the same, they exfoliate the skin and they accelerate cell turnover so that you can shed the damaged skin, the skin that has aged, the skin that has sun damage, the skin that has acne scarring or texture, faster. The other thing that they do is stop pores from being clogged up and epithelializing, so cells abnormally deposit keratin and all of that into these pores. So this is good again, which is another reason why they work so well for clearing up acne. How do you use these?
Well, because they exfoliate the skin and because they accelerate cell turnover, they can potentially be irritating to the skin and this is both retinol and tretinoin, but tretinoin is a lot more irritating to the skin.
So what you can expect when you use either of these is redness that can happen, a feeling of dryness and flakiness that also can happen, skin can feel tighter. So if you are someone with really sensitive skin, probably retinol, and starting on a weak concentration of retinol is going to be more appropriate for you than using tretinoin if you’ve got really sensitive skin, because getting one will irritate it a lot. If you’re someone with kind of normal skin and you have very mild problems, so perhaps you’re in your 20s and you’re just looking for something to improve the skin quality, give it a little bit of a glow, maybe reduce sun damage that’s already maybe happened, and as a preventative to prevent lines and wrinkles from forming, then retinol is much more suitable for you than tretinoin. If you’re someone, however, who’s already got sun damage or you’ve got active acne and that’s ongoing, you’ve got texture or scarring, you’ve got melasma or hyperpigmentation, you’ve already got lines and wrinkles that you want to treat and prevent more from coming, then tretinoin is quite great in that situation.
Again, it’s important to get advice, particularly with tretinoin and see someone who has experience with prescribing and helping people integrate tretinoin into their skincare routine. This is why if you’re in the UK, we offer a virtual skin clinic and our doctors can work with you on tretinoin and also integrate things like that into your skincare routine so that you can get the most out of the tretinoin and your other skincare products.
So tretinoin is great in those situations, in my opinion, and you can get a lot out of it. Just be prepared for some downtime, so you don’t want to start tretinoin if you’ve got an important event coming up. You want to start it a few months before a wedding or a major photo shoot or a celebration, just because the first few weeks there is some downtime to get used to.
That can involve skin, like I said, flaking, looking dry, and looking a bit irritated. Also sometimes, with both retinol and tretinoin, if your skin finds it irritating you might have to reduce the frequency that you use it. So often with tretinoin, when we start people on it, we start them, if they don’t have any problems with sensitivity, we’ll still start them on something like 0.05% and maybe start it every other night or every three nights until their skin gets used to it, and then you work up to once a night, if they get to that point. Some people get to that point sooner than others, some people just need it every other night.
and then the same goes with retinol, if you are starting on retinol, start it every other night initially and don’t go too far too soon.
So once your skin is comfortable with it, you can step it up. Both of these, just like other exfoliants, just like things like exfoliating acids, make your skin even more sensitive to the sun, so you absolutely should be wearing SPF anyway, particularly if you’re going to use retinol or tretinoin. You should be wearing SPF and you should use retinol and tretinoin at night only rather than during the day, be prepared that even if you have oily skin, your skin might feel drier and needs more hydration, so having a really good moisturizer, especially at night, when you’ve applied them on and in the morning. It can sometimes be a little disheartening if you start something and your skin starts to react not so well to it, especially if it’s something that’s supposed to improve your skin, but, a bit of perseverance, remember, with both retinol and tretinoin.
Retinol, in all the studies, it takes about 8 to 12 weeks for people to start seeing an effect, so patience is important. Tretinoin is the same, you need usually about 4 to 6 weeks to start seeing an effect.
There’s no rush, and don’t stress out your skin, because this is a medium to long-term treatment, the effects are great, and they are long-lasting but you need some time. For people who start tretinoin, my patients often ask me before they start, is this something that they have to be on forever? Well, I say, no, actually if we’re starting tretinoin for a specific problem, whether it’s melasma, whether it’s hyperpigmentation, whether it’s acne, any of those things, then no.
We can get to a point where you’re happy with your skin on tretinoin and then step down to retinol. So it’s quite fluid. On the other hand, for some people, actually being on tretinoin, the skin likes it and they can be on it for a long time, for however long they need.
It’s a well-studied ingredient, it’s been around for a long time, as long as it’s prescribed to the right people. Who shouldn’t have retinol or tretinoin?
Well, if you are pregnant or planning a pregnancy, it’s a big no-no; if you are breastfeeding, I would say to stay away from both of these. These are the big no-no’s. Others are, if you’re someone who’s got extremely, extremely sensitive skin, I would say no to tretinoin and even if you start retinol, use this smallest concentration, the lowest concentration you can find and even then, do it once every three days and if your skin doesn’t like it, you just might have to accept that’s a no-no.
Again, if you have rosacea, be careful with anything that can potentially irritate the skin, so I would not, I would say those are the big things and, if you have an allergic reaction to either of those products, then I would say to stay well away from them. The majority of people tolerate tretinoin and definitely retinol really well, as long as you’re not in those groups where I’ve just said stay clear of them.
Anyway, I love tretinoin, I’m a regular user of it, I think it’s great and I think everyone who can be, should at least be using retinol because it’s one of the few anti-ageing ingredients that you can just find over the counter and with some patients it does work and it’s a great preventative and it can also help with skin ageing that’s already set in. If you want any more information about retinol or tretinoin,
Until then, have a great day!