Tretinoin goes by a number of names including Retinoic Acid, Retin A and Vitamin A. In fact, it is part of the retinoid family and a derivative of Vitamin A. It is a highly effective medication that increases the rate of skin cell turnover. In Australia, it's only available via prescription so that doctors can counsel patients on the best way to use and apply it.
Tretinoin is an effective treatment for acne, photoageing (UV induced ageing), irregular pigmentation as well as other skin conditions Dermatologists and GPs often prescribe it as a 'first line' treatment to help manage mild acne, reduce fine lines and wrinkles and to assist to fade irregular pigmentation.
Tretinoin works in a number of ways, some of the key benefits are:
Tretinoin is a prescription medication, only available from a doctor. Its strength and potency distinguishes it from any over-the-counter creams which are typically weaker. It is recognised as a 'silver bullet' by many doctors because of its raft of benefits.
Tretinoin is a retinoid and comes from the same family as retinol - both are a derivative of vitamin A. However, it can be distinguished from retinol, which is available in store because it is less potent, and therefore is classified as a cosmetic (as opposed to a medicine).
Everybody's skin is different - some are more sensitive than others. So it is important that you use the strength of Tretinoin that is best for their skin. Your doctor will help you with this process.
Tretinoin is available in a variety of strengths: 0.025%, 0.05% and 0.1% w/w. Whilst these seem like minuscule amounts, Tretinoin is quite potent. It's best to start on a lower strength and increase it if your skin tolerates the concentration.
Many patients experience dryness, irritation, redness or peeling if they use a concentration that is too strong for their face – or if they use it too frequently. This is often referred to as "retinization" which occurs when the patient's skin does not tolerate the treatment.
There are a number of ways you can manage this transition: you can apply a moisturiser first as a barrier, start by using it less frequently or apply the Tretinoin for a short period each evening, washing it off the face after a few hours. Your doctor will also help you through this process.
If you are using Tretinoin to treat your acne then you may experience some 'purging'. For those prone to acne, there may be a 2-6 week period where you experience acne breakouts before your skin clears up. This is a product of the acne surfacing as the skin cells are regenerated by the Tretinoin.
The key to getting the best results whilst using Tretinoin is to use small amounts, consistently. Patients only need a pea-sized amount to be spread across the face.
For anti-ageing, clinical trials suggest that patients will ordinarily experience the following improvements within the first 3 - 6 months:
If patients are not experiencing any changes after 8-12 weeks, patients may change to a topical combination or try a higher strength (ie from 0.025% to 0.05%).
For acne, patients should see a reduction in the number of comedones or inflammation within the first 12 weeks.
Only use Tretinoin at night because it makes the skin very photosensitive. Be sure to wear a broad-spectrum sunscreen, preferably SPF 30 or SPF 50+, containing a physical barrier (such as titanium dioxide), whilst on the treatment.
Be careful to avoid the more sensitive parts of your face: do not apply too close to the eyes, the lips, the irritated areas or in the creases of your nostrils.
To reduce irritation:
Tretinoin is generally safe for most people to use but you should discuss your skin profile and medical history with your doctor to ensure that it is right for you. For example, it may not be appropriate if you have other skin conditions and it should not be used by women who are breastfeeding, pregnant or trying to conceive.